THAI PHOU – Surgical Physician Assistant, NPI 1023319746
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for THAI PHOU
4338 SUFFOLK ST
RIVERSIDE, CA 925097812
Phone: (909) 226-1100
Type: Mailing
11190 WARNER AVE STE 306
FOUNTAIN VALLEY, CA 927084045
Phone: (714) 432-9990
Type: Location
1840 N HACIENDA BLVD STE 12
LA PUENTE, CA 917441143
Phone: (916) 848-5412
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $255.
Total Amount is formed as General ($255) + Research ($0) + Ownership ($0) = $255.
Last reported payment date: 2023-10-11 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($125).
Total Amount
$255
General + Research + Ownership
Payments
4
Total payment records
General Amount
$255
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-10-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $125 |
| Globus Medical, Inc. | $90 |
| KCI USA, Inc. | $40 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2011-04-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110426000206 | I | Physician Assistant | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| Q4205 | Membrane graft or membrane wrap, per square centimeter | 2,286 | 35 | $0 |
| Q4221 | Amniowrap2, per square centimeter | 1,374 | 30 | $0 |
| Q4204 | Xwrap, per square centimeter | 672 | 21 | $0 |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 414 | 109 | $0 |
| 15271 | Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less | 301 | 49 | $0 |
Insurance plans in this area (ZIP 92509)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | CA | |
| Orthopedic Surgery | CA | |
| Orthopedic Surgery | DC | |
| Physician Assistant | CA |
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