Individual provider Active NPI

Lawrence Threlfall, PA-C

  • Medical Physician Assistant
  • Coarsegold, CA
National Provider Identifier
1609594456
Registry record updated Sep 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
35324 Highway 41
Coarsegold, CA 93614-8302
Phone
(559) 664-4000
NPI assigned
Aug 18, 2022
Last updated
Sep 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

35324 Highway 41
Coarsegold, CA 93614-8302

Mailing address

4809 Timber Wolf TRL
Colorado Springs, CO 80920-7673
Phone (719) 272-1102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20250618001796 CO Practitioner - Physician Assistant 0345619425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Mednow Clinics, IncGroup PAC ID 0042533242, 56 clinicians

Practice addresses (Care Compare)

2960 N Circle Dr
Suite 200
Colorado Springs, CO 80909-1163
Phone (719) 634-8891

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Camarena Health PastSince Aug 28, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lawrence.threlfall.1@14209.direct.athenahealth.com

Organizations & group practices 2

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": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663372800000",
    "number": "1609594456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4809 TIMBER WOLF TRL",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207673",
            "telephone_number": "719-272-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35324 HIGHWAY 41",
            "city": "COARSEGOLD",
            "state": "CA",
            "postal_code": "936148302",
            "telephone_number": "559-664-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THRELFALL",
        "first_name": "LAWRENCE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-09-17",
        "certification_date": "2022-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coarsegold, CA

Sources for this page

Verify at the official NPI Registry.