TIMOTHY ALBERT BANGAYAN LUI (PA-C) – Physician Assistant, NPI 1275018764
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
10,570 PHYSICIAN ASSISTANT in CA
Provider Addresses for TIMOTHY ALBERT BANGAYAN LUI (PA-C)
25751 McBean Pkwy Ste 305
Valencia, CA 913553701
Phone: (661) 799-2542
Fax: (661) 253-0248
Type: Location
1867, Summertime Avenue, Simi Valley, Ventura County, California, 93065, United States
SIMI VALLEY, CA 930656236
Phone: (818) 800-9348
Type: Mailing
McBean Parkway, Valencia, Santa Clarita, Los Angeles County, California, 91355, United States
VALENCIA, CA 913553701
Phone: (661) 799-2542
Fax: (661) 253-0248
Type: Location
PO BOX 255228
SACRAMENTO, CA 958655228
Phone: (800) 470-0071
Fax: (916) 854-6769
Type: Mailing
1625 STOCKTON BLVD STE 207
SACRAMENTO, CA 958167092
Phone: (510) 683-9500
Fax: (877) 880-2039
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2019-03-28
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 |
|---|---|---|---|---|
| I20190328001618 | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 91355)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | NY | |
| - | PA | |
| - | CA | |
| Certified Registered Nurse Anesthetist (Crna) | CA | |
| Physician Assistant | IL | |
| Internal Medicine, Hospice/Palliative Care | CA | |
| Family Practice | CA | |
| - | CA | |
| - | CA | |
| - | CA |
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