Individual provider Active NPI

Brian Suatengco Ngan, FNP-C

  • Family Nurse Practitioner
  • Tarzana, CA
National Provider Identifier
1871261925
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95017432 Issued in CA
Practice address
19353 Victory Blvd
Tarzana, CA 91335-6302
Phone
(818) 996-4742
NPI assigned
Sep 2, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95017432 CA Primary

Addresses

Primary practice location

19353 Victory Blvd
Tarzana, CA 91335-6302

Mailing address

19353 Victory Blvd
Tarzana, CA 91335-6302
Phone (818) 996-4742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211222000825 CA Practitioner - Nurse Practitioner 3678964921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Practice addresses (Care Compare)

20201 Rinaldi St
Suite 110
Northridge, CA 91326-4938
Phone (747) 444-4901

26777 Agoura Rd
Suite B4
Calabasas, CA 91302-2967
Phone (818) 880-2225

35 W Los Angeles Ave
Moorpark, CA 93021-1820
Phone (805) 529-5370

701 N Wendy Dr
Newbury Park, CA 91320-3066
Phone (805) 375-4400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95017432CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Exer Medical Corporation CurrentSince Mar 1, 2024 Accepting new patients

Locations

26777 Agoura Rd
Ste 4
Calabasas, CA 91302
Phone (818) 880-2225

235 E 17th St
Costa Mesa, CA 92627
Phone (949) 688-2010

2381 Rosecrans Ave
Ste 115
El Segundo, CA 90245
Phone (213) 335-7355

7000 Boulder Ave
Ste 103
Highland, CA 92346
Phone (515) 441-6271

35 W Los Angeles Ave
Moorpark, CA 93021
Phone (805) 529-5370

25548 The Old Rd
Ste U1
Stevenson Ranch, CA 91381
Phone (661) 556-9020

701 N Wendy Dr
Thousand Oaks, CA 91320
Phone (805) 375-4400

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1871261925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19353 VICTORY BLVD",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913356302",
            "telephone_number": "818-996-4742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19353 VICTORY BLVD",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913356302",
            "telephone_number": "818-996-4742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGAN",
        "first_name": "BRIAN",
        "middle_name": "SUATENGCO",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

Verify at the official NPI Registry.