Individual provider Active NPI

Timothy Albert Bangayan Lui, PA-C

  • Physician Assistant
  • Sacramento, CA
National Provider Identifier
1275018764
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA56078 Issued in CA
Practice address
1625 Stockton Blvd Ste 207
Sacramento, CA 95816-7092
Phone
(510) 683-9500
Fax
(877) 880-2039
NPI assigned
Oct 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2026

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 PA56078 CA Primary

Addresses

Primary practice location

1625 Stockton Blvd Ste 207
Sacramento, CA 95816-7092

Mailing address

PO Box 255228
Sacramento, CA 95865-5228
Phone (800) 470-0071

Other practice location 1

25751 McBean Pkwy Ste 305
Valencia, CA 91355-3701
Phone (661) 799-2542

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
I20190328001618 CA Practitioner - Physician Assistant 8820338833 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2221 Stockton Blvd
Sacramento, CA 95817-1418
Phone (916) 734-2680

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-2011

2800 L St
Sacramento, CA 95816-5616

2825 Capitol Ave
Sacramento, CA 95816-6039
Phone (916) 454-6600

4860 Y St
Sacramento, CA 95817-2307

4861 Y St
Sacramento, CA 95817-2307
Phone (916) 734-2525

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
64.8
Promoting interoperability
100
Improvement activities
40
Cost
68.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA56078CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca CurrentSince May 15, 2024 Accepting new patients
Regents of the Univ of Ca CurrentSince May 15, 2024 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Feb 23, 2026 Accepting new patients
Sutter Valley Medical Foundation Physician Assistant CurrentSince Feb 23, 2026 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Childrens Hospital of Los Angeles Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

10850 White Rock Rd
Rancho Cordova, CA 95670

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

2221 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-2680

1625 Stockton Blvd
Ste 207
Sacramento, CA 95816
Phone (916) 878-3495

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

2315 Stockton Blvd
Ste 2P101
Sacramento, CA 95817
Phone (800) 282-3284

250 W Main St
Woodland, CA 95695
Phone (916) 668-6100

Organizations & group practices 9

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 3

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": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1275018764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228",
            "telephone_number": "800-470-0071",
            "fax_number": "916-854-6769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 STOCKTON BLVD STE 207",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958167092",
            "telephone_number": "510-683-9500",
            "fax_number": "877-880-2039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25751 McBean Pkwy Ste 305",
            "address_purpose": "LOCATION",
            "city": "Valencia",
            "state": "CA",
            "postal_code": "913553701",
            "country_code": "US",
            "telephone_number": "661-799-2542",
            "fax_number": "661-253-0248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUI",
        "first_name": "TIMOTHY ALBERT",
        "middle_name": "BANGAYAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-01",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA56078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.