Alexis Thompson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA64741 Issued in CA

Practice address

15230 Lakeshore Dr
Clearlake, CA 95422-8107

Phone

(707) 995-4500

Fax

(707) 944-2401

NPI assigned

Nov 26, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Adventist Health Clearlake Hospital Inc.Group PAC ID 3072421197, 84 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Clearlake Hospital, Clearlake, CA, CCN 051317
• Adventist Health Ukiah Valley Hospital, Ukiah, CA, CCN 050301

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Adventist Health Clearlake Hospital Inc.

  • Critical Access Hospital
  • Clearlake, CA
  • NPI 1124018031
  Medicare reassignment Care Compare group NPD
• Adventist Health Clearlake Hospital, Inc

  • Rural Health Clinic/Center
  • Lakeport, CA
  • NPI 1871063040
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventist Health Clearlake Hospital Inc.

  • Critical Access Hospital
  • Clearlake, CA
  • NPI 1124018031
  Care Compare affiliation
• Ukiah Adventist Hospital

  • General Acute Care Hospital
  • Ukiah, CA
  • NPI 1235120676
  Care Compare affiliation

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

{
    "created_epoch": "1574726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1588200463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15230 LAKESHORE DR",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954228107",
            "telephone_number": "707-995-4500",
            "fax_number": "707-944-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15230 LAKESHORE DR",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954228107",
            "telephone_number": "707-995-4500",
            "fax_number": "707-944-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "ALEXIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-26",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kundai Kelvin Tanganyika, M.D
• Alicia Nicole Teferi, M.D
• Putue Teh, PA
• Nichealle Mylenda Thies
• Jayme Thomas
• Janet Lynn Thomson, RRW- 0106
• Thrifty Payless Inc
• Jay El Tillman
• Milagros Tolentino, MD
• Summer Maree Trongo

• Physician Assistant in Clearlake, CA
• Providers in Clearlake, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.