Individual provider Active NPI

Darren Thanh Liem Ngo, MS, MAT, PA-C, ATC

  • Physician Assistant
  • Fremont, CA
National Provider Identifier
1902339005
Registry record updated Oct 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA66435 Issued in CA
Practice address
38690 Stivers St Ste a
Fremont, CA 94536-5276
Phone
(510) 248-1040
Fax
(510) 797-7426
NPI assigned
Apr 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2000031223
Physician Assistant 363A00000X PA66435 CA Primary

Addresses

Primary practice location

38690 Stivers St Ste a
Fremont, CA 94536-5276

Mailing address

38690 Stivers St Ste a
Fremont, CA 94536-5276
Phone (510) 248-1040

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
I20260330003480 CA Practitioner - Physician Assistant 9436634235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

39300 Civic Ctr Dr
Suite 370
Fremont, CA 94538

39300 Civic Ctr Dr
Suite 370
Fremont, CA 94538-2397

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
PA66435CAMDPhysician Assistant

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": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761350400000",
    "number": "1902339005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38690 STIVERS ST STE A",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945365276",
            "telephone_number": "510-248-1040",
            "fax_number": "510-797-7426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38690 STIVERS ST STE A",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945365276",
            "telephone_number": "510-248-1040",
            "fax_number": "510-797-7426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGO",
        "first_name": "DARREN",
        "middle_name": "THANH LIEM",
        "credential": "MS, MAT, PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-05",
        "last_updated": "2025-10-25",
        "certification_date": "2025-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": "2000031223",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA66435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.