Individual provider Active NPI

David Thai, FNP

  • Family Nurse Practitioner
  • Lancaster, CA
National Provider Identifier
1568013142
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95012489 Issued in CA
Practice address
1600 W Avenue J
Lancaster, CA 93534-2814
Phone
(661) 949-5000
NPI assigned
Sep 24, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95012489 CA Primary

Addresses

Primary practice location

1600 W Avenue J
Lancaster, CA 93534-2814

Mailing address

44632 Loneoak Ave
Lancaster, CA 93534-2912
Phone (661) 236-7086

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20200206000567 CA Practitioner - Nurse Practitioner 1355777517 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians
Antelope Valley Emergency Medical Associates IncGroup PAC ID 7517851959, 34 clinicians

Practice addresses (Care Compare)

13652 Cantara St
Panorama City, CA 91402-5423
Phone (818) 375-2000

1600 W Ave J
Lancaster, CA 93534-2814
Phone (661) 949-5000

43112 15TH St W
Lancaster, CA 93534-6219
Phone (661) 726-2378

Hospital & facility affiliations

  • Antelope Valley Hospital Hospital, Lancaster, CA, CCN 050056

Merit-based Incentive Payment System (MIPS)

Final score
97.53 of 100Reported as group
Quality
85.33
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95012489CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Antelope Valley Emergency Medical Associates Inc CurrentSince Nov 15, 2019 Accepting new patients
Southern California Permanente Medical Group CurrentSince May 1, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince May 1, 2023 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

1600 W Avenue J
Lancaster, CA 93534
Phone (661) 726-6254

43112 15th St W
Lancaster, CA 93534
Phone (661) 726-2222

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

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.

Hospital & facility affiliations 1

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": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1568013142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44632 LONEOAK AVE",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342912",
            "telephone_number": "661-236-7086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W AVENUE J",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342814",
            "telephone_number": "661-949-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAI",
        "first_name": "DAVID",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-24",
        "last_updated": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95012489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "43112 15th St W",
            "city": "Lancaster",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935346219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.