Individual provider Active NPI

Peter Y.T. Lai, MD

  • Interventional Cardiology Physician
  • Modesto, CA
National Provider Identifier
1184674459
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
A41316 Issued in CA
Practice address
4368 Spyres Way
Modesto, CA 95356-9259
Phone
(209) 578-6300
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A41316 CA
Cardiovascular Disease Physician 207RC0000X A41316 CA
Interventional Cardiology Physician 207RI0011X A41316 CA Primary

Addresses

Primary practice location

4368 Spyres Way
Modesto, CA 95356-9259

Mailing address

4368 Spyres Way
Modesto, CA 95356-9259
Phone (209) 578-6300

Other identifiers 1

IdentifierTypeStateIssuer
00A413160MedicaidCA

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
I20050103000283 CA Practitioner - Interventional CardiologyPractitioner - Hospice/Palliative CarePractitioner - Cardiovascular Disease (Cardiology) 6305804709 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A41316CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospice, Inc. CurrentSince Jun 26, 2024 Accepting new patients
Community Hospice, Inc. Current Accepting new patients

Locations

4368 Spyres Way
Modesto, CA 95356

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1184674459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4368 SPYRES WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569259",
            "telephone_number": "209-578-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4368 SPYRES WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569259",
            "telephone_number": "209-578-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAI",
        "first_name": "PETER",
        "middle_name": "Y.T.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A41316",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A41316",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A41316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A413160",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.