Individual provider Active NPI

Paul Cheng-Te Niu, M.D.

  • Nephrology Physician
  • Corona, CA
National Provider Identifier
1952336216
Registry record updated Jan 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A46376 Issued in CA
Practice address
2057 Compton Ave
Suite 102
Corona, CA 92881-7287
Phone
(951) 736-6757
Fax
(951) 736-0167
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A46376 CA Primary

Addresses

Primary practice location

2057 Compton Ave
Suite 102
Corona, CA 92881-7287

Mailing address

PO Box 54130
Los Angeles, CA 90054-0130
Phone (951) 687-3400

Other identifiers 1

IdentifierTypeStateIssuer
00A463760MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080527000653 CA Practitioner - NephrologyPractitioner - Internal Medicine 8325930324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Associates Medical Group IncGroup PAC ID 5092604447, 64 clinicians

Practice addresses (Care Compare)

2057 Compton Ave
Suite 102
Corona, CA 92881-7295
Phone (951) 736-6757

Hospital & facility affiliations

  • DaVita Corona Dialysis Center Dialysis facility, Corona, CA, CCN 052661
  • DaVita Riverside Mission Home Training Dialysis facility, Riverside, CA, CCN 552627
  • Corona Regional Medical Center Hospital, Corona, CA, CCN 050329

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
46376CAMDMental Health Counselor
A46376CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates Medical Group Inc Nephrology CurrentSince Jan 1, 2008 Accepting new patients
Nephrology Associates Medical Group, Inc. Past Accepting new patients
Namg Home Dialysis LLC PastSince May 24, 2007 Accepting new patients
Primecare Medical Group Past Accepting new patients

Locations

2057 Compton Ave
Ste 102
Corona, CA 92881
Phone (951) 736-6757

12523 Limonite Ave
Ste 400
Eastvale, CA 91752
Phone (951) 398-6868

425 Diamond Dr
Ste 102
Lake Elsinore, CA 92530
Phone (951) 471-5711

1901 Town and Country Dr
Ste 102
Norco, CA 92860
Phone (951) 736-8100

3660 Park Sierra Dr
Ste 203
Riverside, CA 92505
Phone (951) 687-3400

3660 Park Sierra Dr
Ste 208
Riverside, CA 92505
Phone (951) 687-2800

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: paul.niu.1@19859.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357257600000",
    "number": "1952336216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54130",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900540130",
            "telephone_number": "951-687-3400",
            "fax_number": "951-687-7630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2057 COMPTON AVE",
            "address_2": "SUITE 102",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928817287",
            "telephone_number": "951-736-6757",
            "fax_number": "951-736-0167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIU",
        "first_name": "PAUL",
        "middle_name": "CHENG-TE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2013-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A46376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A463760",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.