Individual provider Active NPI

Jessica Shane Thomas, M.D.

  • Emergency Medicine Physician
  • West Hills, CA
National Provider Identifier
1417274523
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A118566 Issued in CA
Practice address
7300 Medical Center Dr
West Hills, CA 91307-1902
Phone
(818) 676-4999
NPI assigned
Apr 28, 2010
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD.206578 LA
Emergency Medicine Physician 207P00000X A118566 CA Primary

Addresses

Primary practice location

7300 Medical Center Dr
West Hills, CA 91307-1902

Mailing address

PO Box 1551
Thousand Oaks, CA 91358-0551
Phone (805) 300-2904

Other practice location 1

600 S Pine St
Deridder, LA 70634-4942
Phone (805) 300-2904

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
I20180125000532 CA Practitioner - Emergency Medicine 0941431415 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.64 of 100Reported as group
Quality
80.76
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A118566CAMDEmergency Medicine Physician
MD.206578LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tarzana Emergency Medical Associates Emergency Medicine CurrentSince Sep 1, 2022 Accepting new patients
Team Physicians of Northern California Medical Group Inc Emergency Medicine CurrentSince Oct 1, 2021 Accepting new patients

Locations

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

18321 Clark St
Tarzana, CA 91356
Phone (310) 423-6744

7300 Medical Ctr
West Hills, CA 91307
Phone (818) 612-8301

Interoperability endpoints

  • Direct secure messaging: jthomas1271265@direct.uclahealth.org

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1417274523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1551",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913580551",
            "telephone_number": "805-300-2904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 MEDICAL CENTER DR",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913071902",
            "telephone_number": "818-676-4999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 S Pine St",
            "address_purpose": "LOCATION",
            "city": "Deridder",
            "state": "LA",
            "postal_code": "706344942",
            "country_code": "US",
            "telephone_number": "805-300-2904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JESSICA",
        "middle_name": "SHANE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "MD.206578",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A118566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hills, CA

Sources for this page

Verify at the official NPI Registry.