Myla Thong, FNP
Individual provider Active NPI Family Nurse Practitioner · Oakland, CA
NPI 1982162970 · NPPES record last updated Aug 12, 2024
Key facts
- NPI
- 1982162970
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 95011125 (CA)
- Practice address
- 4500 Gilbert St
Oakland, CA 94611-4657 - Phone
- (510) 929-1400
- Fax
- (510) 929-1414
- NPI assigned
- Mar 8, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 14
Hospital & facility affiliations 6
Owned or controlled facilities with NPI records 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2004
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Tyrone E Snipes D O Internal Medicine Primary Care Inc
Lifelong Medical Care
Practice addresses (Care Compare)
3055 Alvarado St
Suite 136
San Leandro, CA 94577-5711
Phone 5104449460321
3260 Sacramento St
Berkeley, CA 94702-2739
Phone (510) 428-4500
Hospital & facility affiliations
- Healthflex Home Health Services
- Mission Home Health of Contra Costa
- Accentcare Home Health of California, Inc
- 1St Choice Home Health Care & Hospice, Inc.
- Aj Home Health, LLC
- Alta Bates Summit Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Attaie Healthcare Inc |
Home health agency | W-2 Managing Employee (100%) Operational/Managerial Control (100%) |
Dec 16, 2019 Dec 16, 2019 |
| Attaie Healthcare Inc |
Hospice | W-2 Managing Employee Operational/Managerial Control |
Dec 16, 2019 Dec 16, 2019 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200715000136 | CA | Practitioner - Nurse Practitioner | 9931533973 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tyrone E Snipes D O Internal Medicine Primary Care Inc | Single Specialty | Current |
Accepting new patients |
| Pine Park Health, Inc | Single Specialty | Current |
Accepting new patients |
Locations
1901 4th St
Ste 201
Berkeley, CA 94710
Phone (469) 401-8820
22445 Cupertino Rd
Cupertino, CA 95014
Phone (408) 253-4300
3850 Walnut Ave
Fremont, CA 94538
Phone (341) 206-8344
16977 Healdsburg Ave
Healdsburg, CA 95448
1144 65th St
Ste F
Oakland, CA 94608
Phone (510) 919-1400
1444 McAllister St
San Francisco, CA 94115
Phone (415) 305-4002
3055 Alvarado St
Ste 136
San Leandro, CA 94577
Phone (510) 444-9460
Interoperability endpoints
- https://api.platform.athenahealth.com/21048/brand/1/csg/1/fhir/r4
- myla.thong@299395540647940.direct.elationemr.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | 95011125 | CA | Yes |
Addresses
Primary practice location
4500 Gilbert St
Oakland, CA 94611-4657
Mailing address
PO Box 511250
Los Angeles, CA 90051-7805
Phone (510) 929-1400
Other providers in Oakland, CA
- Shantoria Shanae Thompson
- Tajanique Thompson
- Tiffany Thompson
- Gary Thomsen
- Janet Thomson
- Teresa Thongsinthusak
- Kathryn Thornburg
- Whitney Thorniley
- Aaron Darryl Thornton
- Camille Thornton
All providers in Oakland, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.