Individual provider Active NPI

Thao M Duong, PA

  • Physician Assistant
  • Irvine, CA
National Provider Identifier
1326326570
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
22273 Issued in CA
Practice address
16 Bel SPGS
Irvine, CA 92602-1019
Phone
(901) 289-7856
NPI assigned
Jul 21, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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 22273 CA Primary

Addresses

Primary practice location

16 Bel SPGS
Irvine, CA 92602-1019

Mailing address

16 Bel SPGS
Irvine, CA 92602-1019

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
I20140327001760 CA Practitioner - Physician Assistant 9436329778 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22273CAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Skilled Facility Health Care Solutions Inc CurrentSince Mar 17, 2014 Accepting new patients
JWCH Institute Inc CurrentSince Oct 14, 2019 Accepting new patients
JWCH Institute Inc CurrentSince Oct 14, 2019 Accepting new patients
Skilled Facility Health Care Solutions Inc CurrentSince Mar 17, 2014 Accepting new patients

Locations

5650 Jillson St
Commerce, CA 90040
Phone (213) 484-1186

3746 Foothill Blvd
La Crescenta, CA 91214
Phone (323) 574-0387

3747 Foothill Blvd
#B140
La Crescenta, CA 91214
Phone 3104455999255

12360 Firestone Blvd
Norwalk, CA 90650
Phone (562) 281-0305

6401 33rd St
Riverside, CA 92509
Phone (909) 681-2200

1340 15th St
Santa Monica, CA 90404
Phone (310) 451-9700

Interoperability endpoints

  • Direct secure messaging: thao.dunogpa.p1@direct.jwch.nextgenshare.com

Organizations & group practices 4

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": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1326326570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 BEL SPGS",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926021019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 BEL SPGS",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926021019",
            "telephone_number": "901-289-7856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUONG",
        "first_name": "THAO",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-21",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "22273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.