Individual provider Active NPI

Suzanne Vashishta, PA-C

  • Physician Assistant
  • Newport Beach, CA
National Provider Identifier
1972050060
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA55462 Issued in CA
Practice address
22 Corporate Plaza Dr
Newport Beach, CA 92660-7985
Phone
(949) 722-5088
NPI assigned
Sep 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA55462 CA Primary

Addresses

Primary practice location

22 Corporate Plaza Dr
Newport Beach, CA 92660-7985

Mailing address

22 Corporate Plaza Dr
Newport Beach, CA 92660-7985

Other names 1

  • Suzanne Park Former name

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
I20181017000788 CA Practitioner - Physician Assistant 2062770100 Reassigns benefits to 1 organization

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
Orthopedic Institute of Newport Beach Limited PartnershipGroup PAC ID 4688826688, 30 clinicians
Southern California Permanente Medical GroupGroup PAC ID 6002729175, shared by 4 NPIs, 11,250 clinicians

Practice addresses (Care Compare)

22 Corporate Plaza Dr
Newport Beach, CA 92660-7985
Phone (949) 722-7038

5475 E la Palma Ave
Anaheim, CA 92807-2075
Phone (714) 279-6088

6640 Alton Pkwy
Irvine, CA 92618-3734
Phone (949) 932-5000

6650 Alton Pkwy
Irvine, CA 92618-3734
Phone (949) 932-5000

6670 Alton Pkwy
Irvine, CA 92618-3734
Phone (949) 932-5000

Hospital & facility affiliations

  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

Merit-based Incentive Payment System (MIPS)

Final score
92.23 of 100Reported as group
Quality
99.26
Improvement activities
40
Cost
75.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA55462CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
NPI 1972355329 CurrentSince Apr 11, 2022 Accepting new patients

Locations

22 Corporate Plaza Dr
Newport Beach, CA 92660
Phone (949) 472-2703

Interoperability endpoints

  • Direct secure messaging: suzanne.vashishta.p1@direct.newportortho.nextgenshare.com

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.

Hospital & facility affiliations 1

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": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1972050060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 CORPORATE PLAZA DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 CORPORATE PLAZA DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607985",
            "telephone_number": "949-722-5088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASHISHTA",
        "first_name": "SUZANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-06",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA55462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZANNE",
            "last_name": "PARK",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.