Mikey Thanteraphong

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95013063 Issued in CA

Practice address

2845 Cochran St Ste B
Simi Valley, CA 93065-7905

Phone

(818) 835-7355

NPI assigned

Nov 26, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Agoura Hills Urgentocare PCGroup PAC ID 3476981226, 13 clinicians

Anvar Medical GroupGroup PAC ID 4284875451, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Agoura Hills Urgentocare PC

  • Urgent Care Clinic/Center
  • Agoura Hills, CA
  • NPI 1043840465
  Medicare reassignment Care Compare group NPD
• Anvar Medical Group

  • Urgent Care Clinic/Center
  • Northridge, CA
  • NPI 1831539485
  Medicare reassignment Care Compare group NPD
• First Aid Urgent Care Inc

  • Urgent Care Clinic/Center
  • Tujunga, CA
  • NPI 1760889190
  Medicare reassignment NPD
• Edu Advanced Nursing, Inc

  • Nurse Practitioner
  • Simi Valley, CA
  • NPI 1942078332
  NPD Authorized official
• Anaheim Urgent Care, Inc.

  • Urgent Care Clinic/Center
  • Anaheim, CA
  • NPI 1962680033
  NPD (past)
• RPMD Medical, PC

  • Family Nurse Practitioner
  • Simi Valley, CA
  • NPI 1447123526
  NPD (past)
• Valley Urgent Care

  • Urgent Care Clinic/Center
  • Northridge, CA
  • NPI 1740347913
  NPD (past)

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

{
    "created_epoch": "1574726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1437795333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 336",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913760336",
            "telephone_number": "818-835-7355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 COCHRAN ST STE B",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930657905",
            "telephone_number": "818-835-7355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THANTERAPHONG",
        "first_name": "MIKEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-26",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95013063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa M Teevan, NP
• Sofia Fernanda Teran Mendoza
• Blake Terry, DC
• Happy D Thakkar, M.D.
• Ushakant Thakkar, M.D.
• The Hand & Upper Extremity Center Inc
• The Samaritan Center - Simi Valley
• The Therapist Den
• The Ultimate Hospice Care Services Providers, Inc.
• The Whole Woman, Incorporated

• Nurse Practitioner in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.