Individual provider Active NPI

Levon James Thomas, PA-C

  • Physician Assistant
  • Riverside, CA
National Provider Identifier
1912299124
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA21535 Issued in CA
Practice address
6405 Day St
Riverside, CA 92507-0901
Phone
(951) 697-5611
Fax
(951) 697-5565
NPI assigned
May 5, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 50004142 OH
Physician Assistant 363A00000X PA21535 CA Primary

Addresses

Primary practice location

6405 Day St
Riverside, CA 92507-0901

Mailing address

6405 Day St
Riverside, CA 92507-0901
Phone (951) 697-5611

Other practice location 1

255 Terracina Blvd Ste 101
Redlands, CA 92373-4870
Phone (909) 074-8656

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
I20110929000532 CA Practitioner - Physician Assistant 5496926172 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21535CAMDSpeech-Language Pathologist
PA21535CAMDPhysician Assistant
50004142OHMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Medical Clinic, Inc CurrentSince Dec 18, 2024 Accepting new patients
Riverside Medical Clinic, Inc CurrentSince Dec 18, 2024 Accepting new patients

Locations

6405 Day St
Riverside, CA 92507
Phone (909) 683-6370

3660 Arlington Ave
Riverside, CA 92506
Phone (951) 782-3789

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.

NPI Registry JSON

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

{
    "created_epoch": "1304553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1912299124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6405 DAY ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925070901",
            "telephone_number": "951-697-5611",
            "fax_number": "951-697-5565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 DAY ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925070901",
            "telephone_number": "951-697-5611",
            "fax_number": "951-697-5565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 Terracina Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Redlands",
            "state": "CA",
            "postal_code": "923734870",
            "country_code": "US",
            "telephone_number": "909-074-8656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "LEVON",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-05",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50004142",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.