Individual provider Active NPI

Tawnie Thao Cao, PA-C

  • Physician Assistant
  • Long Beach, CA
National Provider Identifier
1497205462
Registry record updated Apr 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA55461 Issued in CA
Practice address
2110 N Bellflower Blvd
Long Beach, CA 90815-3126
Phone
(562) 346-2222
NPI assigned
Oct 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2018

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 PA55461 CA Primary

Addresses

Primary practice location

2110 N Bellflower Blvd
Long Beach, CA 90815-3126

Mailing address

2110 N Bellflower Blvd
Long Beach, CA 90815-3126
Phone (562) 346-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170117000108 NY Practitioner - Physician Assistant 4183906712 Reassigns benefits to 1 organization
I20190411002229 CA Practitioner - Physician Assistant 4183906712 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

15464 Goldenwest St
Westminster, CA 92683-6149
Phone (714) 891-9008

2110 N Bellflower Blvd
Long Beach, CA 90815-3126
Phone (562) 346-2222

3828 Schaufele Ave
Long Beach, CA 90808-1793

722 Baker St
Costa Mesa, CA 92626-4320
Phone (714) 557-6300

Merit-based Incentive Payment System (MIPS)

Final score
87.17 of 100Reported as group
Quality
81.15
Promoting interoperability
100
Improvement activities
40
Cost
71.64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA55461CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Dec 15, 2016 Accepting new patients
Montefiore Medical Center CurrentSince Dec 15, 2016 Accepting new patients
York Hospital Past Accepting new patients
Bristol Park Medical Group, Inc Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

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.

NPI Registry JSON

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1497205462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 N BELLFLOWER BLVD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908153126",
            "telephone_number": "562-346-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 N BELLFLOWER BLVD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908153126",
            "telephone_number": "562-346-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAO",
        "first_name": "TAWNIE",
        "middle_name": "THAO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-13",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA55461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.