Individual provider Active NPI

David Thornsberry, PA-C

  • Physician Assistant
  • Laguna Niguel, CA
National Provider Identifier
1982889135
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 19559 Issued in CA
Practice address
27020 Alicia Pkwy Ste G
Laguna Niguel, CA 92677-3420
Phone
(949) 707-5734
NPI assigned
Jan 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 19559 CA Primary

Addresses

Primary practice location

27020 Alicia Pkwy Ste G
Laguna Niguel, CA 92677-3420

Mailing address

27020 Alicia Pkwy
Ste G
Laguna Niguel, CA 92677-3420
Phone (949) 707-5734

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
I20160915000641 CA Practitioner - Physician Assistant 8527354638 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19559CAMDMental Health Counselor
PA 19559CAMDPhysician Assistant

Organizations & group practices 1

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": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471478400000",
    "number": "1982889135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27020 ALICIA PKWY",
            "address_2": "STE G",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926773420",
            "telephone_number": "949-707-5734",
            "fax_number": "949-707-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27020 ALICIA PKWY STE G",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926773420",
            "telephone_number": "949-707-5734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNSBERRY",
        "first_name": "DAVID",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-07",
        "last_updated": "2016-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 19559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Niguel, CA

Sources for this page

Verify at the official NPI Registry.