Individual provider Active NPI

Thilan P.J. Fernando, M.D.

  • Family Medicine Physician
  • Downey, CA
National Provider Identifier
1316146632
Registry record updated Jun 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A97365 Issued in CA
Practice address
11480 Brookshire Ave
Suite #204
Downey, CA 90241-5018
Phone
(562) 282-2775
Fax
(562) 904-8095
NPI assigned
Jul 16, 2007
Last updated
Jun 2, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A97365 CA Primary

Addresses

Primary practice location

11480 Brookshire Ave
Suite #204
Downey, CA 90241-5018

Mailing address

75 Remittance Drive Dept 6008
Chicago, IL 60675-6008
Phone (562) 282-1419

Other identifiers 1

IdentifierTypeStateIssuer
00A973650MedicaidCA

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
I20081024000451 CA Practitioner - Family Practice 2062570781 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Georgetown University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pih Health PhysiciansGroup PAC ID 8426951328, 616 clinicians

Practice addresses (Care Compare)

4476 Tweedy Blvd
South Gate, CA 90280-6359
Phone (323) 563-9499

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.61 of 100Reported as group
Quality
58.7
Improvement activities
40
Cost
75.08

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A97365CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pih Health Physicians CurrentSince Aug 15, 2020 Accepting new patients
Pioneer Medical Group Inc. CurrentSince Jul 14, 2008 Accepting new patients
Pih Health Physicians Family Medicine Current Accepting new patients
Pih Health Physicians CurrentSince Aug 15, 2020 Accepting new patients
Pih Health Downey Hospital Past Accepting new patients
Bright Medical Associates, Inc. Past Accepting new patients

Locations

11480 Brookshire Ave
Downey, CA 90241
Phone (562) 862-0804

11480 Brookshire Ave
Ste 204
Downey, CA 90241
Phone (562) 862-2775

12214 Lakewood Blvd
Ste 110
Downey, CA 90242
Phone (562) 862-2775

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

2220 Clark Ave
Long Beach, CA 90815
Phone (562) 597-4181

4476 Tweedy Blvd
South Gate, CA 90280
Phone (323) 563-9499

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: thilanfernando@pihh.allscriptsdirect.net

Organizations & group practices 6

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 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": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1316146632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 REMITTANCE DRIVE DEPT 6008",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606756008",
            "telephone_number": "562-282-1419",
            "fax_number": "562-920-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11480 BROOKSHIRE AVE",
            "address_2": "SUITE #204",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902415018",
            "telephone_number": "562-282-2775",
            "fax_number": "562-904-8095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDO",
        "first_name": "THILAN",
        "middle_name": "P.J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-16",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A97365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A973650",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

Verify at the official NPI Registry.