NPIMap

Individual provider Active NPI

Robert Thayer, DO

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1396199378
Registry record updated Dec 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A17097 Issued in CA
Practice address
1300 N Vermont Ave
Los Angeles, CA 90027-6098
Phone
(323) 913-4387
Fax
(323) 953-6338
NPI assigned
Apr 15, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A17097 CA Primary

Addresses

Primary practice location

1300 N Vermont Ave
Los Angeles, CA 90027-6098

Mailing address

418 S Electric Ave Apt a
Alhambra, CA 91803-1656
Phone (858) 539-3286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200217004154 CA Practitioner - Internal Medicine 5395172134 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Arizona College of Osteopathic Medicine Mid Western University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dr Mona Shah Professional CorporationGroup PAC ID 2062548084, 11 clinicians

Practice addresses (Care Compare)

1600 S Gaffey St
San Pedro, CA 90731-4628
Phone (310) 548-0201

Hospital & facility affiliations

  • Providence Little Co of Mary Med Ctr San Pedro Hospital, San Pedro, CA, CCN 050078
  • White Point Care Center Nursing home, San Pedro, CA, CCN 055527
  • Seacrest Post-Acute Care Center Nursing home, San Pedro, CA, CCN 055070

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A17097CAMDInternal Medicine Physician

Practice roles (6 of 7)

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince May 24, 2024 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Internal Medicine CurrentSince May 24, 2024 Accepting new patients
Sycamore Hill Hospitalist Medical Group Inc CurrentSince Jan 15, 2020 Accepting new patients
Dr Mona Shah Professional Corporation Internal Medicine CurrentSince May 1, 2021 Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Cha Hollywood Medical Center, LP Past Accepting new patients

Locations

5525 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 644-6600

1300 N Vermont Ave
Los Angeles, CA 90027
Phone (213) 413-3000

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

1600 S Gaffey St
San Pedro, CA 90731
Phone (310) 548-0201

621 S Butte St
San Pedro, CA 90732
Phone (310) 548-1422

1366 W 7th St
San Pedro, CA 90732
Phone (310) 548-0478

1294 W 6th St
Ste 205
San Pedro, CA 90731
Phone (310) 548-0201

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1460678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1396199378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 S ELECTRIC AVE APT A",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918031656",
            "telephone_number": "858-539-3286",
            "fax_number": "602-344-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276098",
            "telephone_number": "323-913-4387",
            "fax_number": "323-953-6338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAYER",
        "first_name": "ROBERT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-15",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A17097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.