Individual provider Active NPI

Kaitlyn Vu

  • Medical Physician Assistant
  • Long Beach, CA
National Provider Identifier
1952850364
Registry record updated Sep 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
53696 Issued in CA
Practice address
2690 Pacific Ave Ste 290
Long Beach, CA 90806-2631
Phone
(562) 595-9799
NPI assigned
Sep 26, 2016
Last updated
Sep 26, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 53696 CA Primary

Addresses

Primary practice location

2690 Pacific Ave Ste 290
Long Beach, CA 90806-2631

Mailing address

13171 Westlake St Apt C
Garden Grove, CA 92843-2499
Phone (714) 902-4380

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
I20161028001849 CA Practitioner - Physician Assistant 0840578621 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Physicians Medical Group IncGroup PAC ID 8527963487, 7 clinicians

Practice addresses (Care Compare)

1974 Santa Fe Ave
Long Beach, CA 90810-4064
Phone (562) 595-9799

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Long Beach Memorial Medical Past Accepting new patients
Newport Harbor Otology Associates and Ear Medical Group Inc. Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1474848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474848000000",
    "number": "1952850364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13171 WESTLAKE ST APT C",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928432499",
            "telephone_number": "714-902-4380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2690 PACIFIC AVE STE 290",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062631",
            "telephone_number": "562-595-9799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VU",
        "first_name": "KAITLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-26",
        "last_updated": "2016-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "53696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.