BAOTRAM NGOC LUU (NPI# 1194130328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194130328 |
| Entity Type | Individual |
| Full Name | BAOTRAM NGOC LUU |
| Credential | PA-C, MPAS |
| Practice Address |
One Medical Center Blvd Suite 404 Upland PA 19013 |
| Practice Telephone | 6106198590 |
| Practice Fax Number | 6106198591 |
| Mailing Telephone | 6106198590 |
| Mailing Fax Number | 6106198591 |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2014-07-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | MA051657 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
MA051657 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
ONE MEDICAL CENTER BLVD SUITE 404 |
| City | UPLAND |
| State | PA |
| Zip Code | 19013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023014628 | Calvin Randolph Stafford Jr. | Psychiatry & Neurology | One Medical Center Blvd, Suite 533, Upland, PA 19013-3902 | 2005-06-28 |
| 1609495035 | Lindsay Alexandra West | Student in an Organized Health Care Education/Training Program | One Medical Center Blvd, Acp Suite 332, Upland, PA 19013 | 2020-04-15 |
| 1780171876 | Alice Shen | Student in an Organized Health Care Education/Training Program | One Medical Center Blvd, Department of Medicine, Third Floor, East Wing, Upland, PA 19013 | 2018-04-16 |
| 1679002083 | Kirankumar Patel | Internal Medicine | One Medical Center Blvd, Department of Medicine 3 East, Upland, PA 19013 | 2017-06-08 |
| 1821424102 | Andrew Joseph Mehalick | Internal Medicine | One Medical Center Blvd, Bldg 1 - Suite 400, Upland, PA 19013 | 2013-09-18 |
| 1790048437 | Michael Andrew Lashner | Internal Medicine | One Medical Center Blvd, Bldg 1 - Suite 400, Upland, PA 19013 | 2012-06-18 |
| 1437411352 | Crozer Chester Medical Center | General Acute Care Hospital | One Medical Center Blvd, Acp 332, Upland, PA 19013 | 2012-06-15 |
| 1306112644 | Dexter Doromal Jacob | Internal Medicine | One Medical Center Blvd, Bldg 1 Ste 400, Upland, PA 19013-3902 | 2012-03-30 |
| 1831408871 | Aashay Navin Patel | Internal Medicine | One Medical Center Blvd, Suite 404, Upland, PA 19013-3902 | 2010-09-24 |
| 1144549536 | Premier Orthopaedic and Sports Medicine Associates, Ltd | Durable Medical Equipment & Medical Supplies | One Medical Center Blvd, Ccmc Prof Office Bldg II Ste 320, Upland, PA 19013 | 2010-05-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790305043 | Erika Pack | Student in an Organized Health Care Education/Training Program | Crozer-chester Medical Center, 1 Medical Center Blvd., Upland, PA 19013 | 2020-04-16 |
| 1477195287 | Andrew Matthews | Counselor | 301 West 15 Street, Chester, PA 19013 | 2019-10-14 |
| 1780241133 | Raashidah Elizabeth Bowman | Contractor | 1208 Remington Street, Chester, PA 19013 | 2019-05-21 |
| 1134609464 | Shamira Clintonia Johnson | Nurse's Aide | 217 W 5th St, Chester, PA 19013 | 2018-08-16 |
| 1871081299 | Michael Briskey | Student in an Organized Health Care Education/Training Program | 1 Medical Center Blv.d, Chester, PA 19013 | 2018-05-01 |
| 1356845499 | Sonia Gaur | Internal Medicine | 1 Medical Center Blvd Fl 3, Chester, PA 19013 | 2018-03-22 |
| 1548619232 | Beth Barol | Social Worker | 1602 Walnut St, Center for Social Work Education, Chester, PA 19013 | 2016-06-03 |
| 1235594888 | Eryka Jackson | Counselor | 516 West 5th Street, Chester, PA 19013 | 2015-12-28 |
| 1437553146 | Erin Hipple | Counselor | 200 West 9th St, Chester, PA 19013 | 2014-10-09 |
| 1588079867 | Crozer Chester Medical Center | Clinic/Center | 201 Bridgewater Road, Chester Township, PA 19013 | 2014-06-25 |
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| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891004271 | Allyson Nicole Kochsmeier | Physician Assistant | 2084 West Arrow Route, Apartment Number 615, Upland, CA 91786-2800 | 2010-10-01 |
| 1588853675 | Kevin John Wansor | Physician Assistant | 30 Medical Center Blvd Suite 303, Clinical Renal Associates Ltd, Upland, PA 19013-3995 | 2007-10-15 |
| 1811109168 | Lynne Anne Drewes | Physician Assistant | 358 Deborah Ct, Upland, CA 91784-1456 | 2007-05-07 |
| 1922643931 | Angie Ling | Physician Assistant | 999 San Bernardino Rd, Upland, CA 91786-4920 | 2019-11-13 |
| 1902378979 | Michael S Yeh | Physician Assistant | 999 San Bernardino Rd, Upland, CA 91786-4920 | 2019-01-01 |
| 1295104602 | Caitlin Matsumoto | Physician Assistant | 299 W Foothill Blvd Ste 209, Upland, CA 91786-3806 | 2015-09-16 |
| 1982072682 | Kristin Mickelson | Physician Assistant | 585 N Mountain Ave, Suite A, Upland, CA 91786-8516 | 2015-09-11 |
| 1730557794 | Brian Chen | Physician Assistant | 367 N 2nd Ave, Upland, CA 91786-6006 | 2015-09-08 |
| 1588974661 | Daicy Maria Navarro | Physician Assistant | 984 W Foothill Blvd, Upland, CA 91786-3700 | 2010-10-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497355341 | Julia Majewicz Wilson | Physician Assistant | 111 Pa-715, #102, Brodheadsville, PA 18322 | 2020-10-29 |
| 1417557273 | Jared Michael Yon | Physician Assistant | 902 Dale Ave, Bradfordwoods, PA 15015-1236 | 2020-10-29 |
| 1295335230 | Jillian Ann Korgeski | Physician Assistant | 400 Corner St, Dunmore, PA 18512-2348 | 2020-10-29 |
| 1821697376 | Sidney Patel | Physician Assistant | 1834 Oregon Pike Ste 20, Lancaster, PA 17601-6463 | 2020-10-25 |
| 1629677356 | Jason Christopher Takacs Jr. | Physician Assistant | 510 Stockton Rdg, Cranberry Township, PA 16066-2280 | 2020-10-23 |
| 1467051763 | Molly Catherine Peters | Physician Assistant | 4338 Boone St, Philadelphia, PA 19128-4901 | 2020-10-19 |
| 1508465840 | Tran Quyen Tran | Physician Assistant | 2941 Hillside Rd, Broomall, PA 19008-1304 | 2020-10-19 |
| 1275132656 | Jessica Haley Stecklein | Physician Assistant | 696 Fir Ave, Langhorne, PA 19047-5450 | 2020-10-18 |
| 1083212625 | Kele Ferreira | Physician Assistant | 1201 Sandhill Rd, Lebanon, PA 17046-1943 | 2020-10-15 |
| 1386251619 | Nicholas James Lazorka | Physician Assistant | 195 Chapmans Round Top Rd, Montoursville, PA 17754-7508 | 2020-09-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.