Individual provider Active NPI

George Thomas, PA-C

  • Physician Assistant
  • Lawndale, CA
National Provider Identifier
1255963146
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
58186 Issued in CA
Practice address
15009 Eastwood Ave
Lawndale, CA 90260-1726
Phone
(214) 683-4279
NPI assigned
Feb 7, 2020
Last updated
Sep 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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 58186 CA Primary

Addresses

Primary practice location

15009 Eastwood Ave
Lawndale, CA 90260-1726

Mailing address

15009 Eastwood Ave
Lawndale, CA 90260-1726
Phone (214) 683-4279

Other practice location 1

2508 Pecan Grove Ct
Irving, TX 75060-6500
Phone (214) 683-4279

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
I20200701001125 CA Practitioner - Physician Assistant 3678996147 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wound Docs ApcGroup PAC ID 2860928629, 23 clinicians
Izuchukwu Okpara MD IncGroup PAC ID 1052698966, 45 clinicians

Practice addresses (Care Compare)

1703 Termino Ave
Suite 106
Long Beach, CA 90804-2126
Phone (562) 800-3321

28212 Kelly Johnson Pkwy
Suite 200
Valencia, CA 91355-5090
Phone (213) 228-3538

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Mobile Physicians Network, Inc PastSince Jun 1, 2020 Accepting new patients

Organizations & group practices 3

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": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1255963146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15009 EASTWOOD AVE",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902601726",
            "telephone_number": "214-683-4279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15009 EASTWOOD AVE",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902601726",
            "telephone_number": "214-683-4279"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2508 Pecan Grove Ct",
            "address_purpose": "LOCATION",
            "city": "Irving",
            "state": "TX",
            "postal_code": "750606500",
            "country_code": "US",
            "telephone_number": "214-683-4279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "GEORGE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-07",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "58186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawndale, CA

Sources for this page

Verify at the official NPI Registry.