Deactivated NPI 1568875433 Deactivated / Inactive NPI Male Practitioner

Logan Jensen

Physician Assistant • Costa Mesa, CA

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Logan Jensen has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 08, 2014

NPI Deactivation Date August 09, 2023

Total Practice Duration ~9 Years of Practice (2014 – 2023)

Professional Overview & Biography Verified Profile Summary

Logan Jensen was a registered Physician Assistant practicing in Costa Mesa, CA. Throughout an active medical career spanning 9 years, Logan Jensen provided care at the practice location at 275 VICTORIA ST until profile deactivation on 2023-08-09.

Historical Medicare Part B clinical services included subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least, subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least, initial nursing facility visit. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

275 Victoria St
Ste 2l

Costa Mesa, CA 926271906

Telephone 9497227118

Associated Practice Facility / Clinic

🏢 Newport Mesa Medical Group, Inc Facility NPI 1104836956

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Costa Mesa, CA

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 7.0 Yrs

State Avg: 11.5 Yrs

Regional Practice Density

38 Specialists

Practicing in Costa Mesa, CA (14617 Statewide)

Telehealth Adoption Rate

18.4% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

26.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2023)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	209	140	$150.00	$97.09
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	133	114	$100.00	$67.76
99306 Initial nursing facility visit, typically 45 minutes per day	51	50	$200.00	$164.25

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	636	241	$150.00	$82.73
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	597	231	$100.00	$62.68
99306 Initial nursing facility visit, typically 45 minutes per day	240	210	$200.00	$149.07
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	65	59	$170.00	$116.60
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	23	19	$150.00	$81.79

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	415	217	$150.00	$83.88
99306 Initial nursing facility visit, typically 45 minutes per day	267	214	$200.00	$152.23
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	259	154	$100.00	$63.52
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	119	82	$150.00	$83.86
99306 Initial nursing facility visit, typically 45 minutes per day	59	58	$200.00	$151.60
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	56	51	$170.00	$118.58
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	40	25	$100.00	$63.52

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	286	154	$150.00	$81.84
99306 Initial nursing facility visit, typically 45 minutes per day	126	114	$200.00	$147.86
99306 Initial nursing facility visit, typically 45 minutes per day	124	116	$200.00	$148.83
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	107	94	$100.00	$61.95
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	75	65	$150.00	$81.51
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	54	26	$75.00	$41.82
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	46	33	$100.00	$62.06
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	14	14	$170.00	$115.62
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	14	14	$170.00	$115.31

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	71	69	$100.00	$63.08
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	40	36	$100.00	$63.08
99306 Initial nursing facility visit, typically 45 minutes per day	17	17	$200.00	$151.90
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	14	14	$170.00	$118.59

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
90792 Psychiatric diagnostic evaluation with medical services	453	379	$200.00	$132.43
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	451	225	$149.96	$82.38
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	181	94	$100.00	$62.49
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	83	40	$150.00	$82.41
90792 Psychiatric diagnostic evaluation with medical services	59	42	$200.00	$124.56
99335 Established patient assisted living visit, typically 25 minutes	48	17	$130.00	$84.96
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	17	11	$100.00	$62.44

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	470	223	$150.01	$82.12
90792 Psychiatric diagnostic evaluation with medical services	298	248	$200.34	$128.76
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	223	124	$159.53	$82.09
90792 Psychiatric diagnostic evaluation with medical services	190	166	$227.37	$124.19
99335 Established patient assisted living visit, typically 25 minutes	179	43	$130.00	$85.23
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	147	91	$100.00	$62.05
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	144	121	$124.65	$61.90
99336 Established patient assisted living visit, typically 40 minutes	49	30	$180.00	$121.21

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License CA 51530

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

37 Associated Practitioners

Kelly Eguchi

Nurse Practitioner - Psychiatric/Mental Health

NPI 1013453612

Maria Trippel , PMHNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1063123925

Psychiatric-Mental Health Nurse Practitioner

Jason Giang , MSW

Social Worker - Clinical

NPI 1104440163

Master of Social Work

Dr. Linda Trinh , NP, DNP

Nurse Practitioner

NPI 1124333828

Nurse Practitioner, Doctor of Nursing Practice

Cindy Capretz , LCSW

Social Worker - Clinical

NPI 1134409907

Licensed Clinical Social Worker

Johnny Gallegos , APCC

Counselor - Mental Health

NPI 1134982515

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events

⚠️

NPI Profile Deactivated August 09, 2023

Record deactivated on August 09, 2023

📍

Updated Practice Location July 02, 2019

Registered at 17782 COWAN STE A, IRVINE, CA 926146041 (Tel: 9497227118)

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Updated Business Mailing Address July 02, 2019

Registered at 1048 IRVINE AVE # 1056, NEWPORT BEACH, CA 926604602 (Tel: 9499552101)

✅

NPI Profile Active June 08, 2014

NPI status registered as active in NPPES database

📍

Updated Practice Location June 08, 2014

Registered at 275 VICTORIA ST, STE 2L, COSTA MESA, CA 926271906 (Tel: 9497227118)

📍

Updated Business Mailing Address June 08, 2014

Registered at 275 VICTORIA ST, STE 2L, COSTA MESA, CA 926271906 (Tel: 9497227118)

👤

Provider Name / Credentials Updated June 08, 2014

Recorded as LOGAN JENSEN

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 08, 2014

Physician Assistant (License #51530 in CA)

🟢

Initial NPI Registration & Enumeration June 08, 2014

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1568875433

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 08, 2014

Last Update: June 08, 2014

Deactivation Date: August 09, 2023

Update or Correct Profile

Mailing Address

275 Victoria St, Ste 2l

Costa Mesa, CA 926271906

Phone: 9497227118

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.