Individual provider Active NPI

Tim Tien Lai, M.D.

  • Neurology Physician
  • Fountain Valley, CA
National Provider Identifier
1295094324
Registry record updated Mar 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A128380 Issued in CA
Practice address
11100 Warner Ave
Ste 152
Fountain Valley, CA 92708-7510
Phone
(714) 486-2521
Fax
(714) 486-2613
NPI assigned
May 9, 2012
Last updated
Mar 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X A128380 CA Primary

Addresses

Primary practice location

11100 Warner Ave
Ste 152
Fountain Valley, CA 92708-7510

Mailing address

11100 Warner Ave
Ste 152
Fountain Valley, CA 92708-7510
Phone (714) 486-2521

Other names 1

  • Tien Thang Lai Former name

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
I20170626001486 CA Practitioner - NeurologyPractitioner - Other (Physician) 1951617356 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
State University of New York at Buffalo School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Choice Aco IncGroup PAC ID 7719379395, 60 clinicians

Practice addresses (Care Compare)

11100 Warner Ave
Suite 152
Fountain Valley, CA 92708-7510

7631 Wyoming St
Suite 201
Westminster, CA 92683-3904
Phone (714) 898-0765

8342 Garden Grove Blvd
Suite 7
Garden Grove, CA 92844-1151
Phone (714) 486-2521

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A128380CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Choice Aco Inc CurrentSince Oct 19, 2021 Accepting new patients
Tim T. Lai, MD, Inc. Neurology CurrentSince Jul 1, 2017 Accepting new patients

Locations

11100 Warner Ave
Ste 152
Fountain Valley, CA 92708
Phone (714) 432-1212

8342 Garden Grove Blvd
Ste 7
Garden Grove, CA 92844
Phone (714) 486-2521

7631 Wyoming St
Ste 201
Westminster, CA 92683
Phone (714) 898-0765

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1336521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585440000000",
    "number": "1295094324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "STE 152",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087510",
            "telephone_number": "714-486-2521",
            "fax_number": "714-486-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "STE 152",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087510",
            "telephone_number": "714-486-2521",
            "fax_number": "714-486-2613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAI",
        "first_name": "TIM",
        "middle_name": "TIEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-09",
        "last_updated": "2020-03-29",
        "certification_date": "2020-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A128380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIEN",
            "last_name": "LAI",
            "middle_name": "THANG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.