JU-EN C THLICK – Gastroenterology Physician, NPI 1386878262

JU-EN C THLICK is a healthcare provider. based in Baldwin park, California. specializing in GASTROENTEROLOGY, INTERNAL MEDICINE. They hold a License No. A120968 (CA). The NPI Number for JU-EN C THLICK is 1386878262

Main info

Male
17 Years Of Experience
Accepts Medicare Assignment
Name
JU-EN C THLICK
NPI
1386878262
Phone
Not provided
Address
1011 BALDWIN PARK BLVD
Enumeration Date
7 May 2009
Last Update Date
29 November 2021

Doctor Profile

Medical School Name
ALBERT EINSTEIN COLLEGE OF MEDICINE OF YESHIVA UNIVERSITY
Secondary Phone
8776080044
Graduation Year
2009 (17 years ago)
PAC ID
9436384401
Group Practice PAC ID
6002729175
Professional Enrollment ID
I20131029000056
Address ID
CA917066807IR12761AVEX300

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness85
Years active:17State licenses:1Other namesUpdated within 12 months

1,981 GASTROENTEROLOGY in CA

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Provider Addresses for JU-EN C THLICK

  • Kaiser Permanente Baldwin Park Medical Center, 1011, Baldwin Park Boulevard, Baldwin Park, Los Angeles County, California, 91706, United States

    BALDWIN PARK, CA 917065806

    Phone:

    Mailing address matches the actual address.

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: 2013-10-29

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20131029000056IGastroenterologyCATBD

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.

Verify on CMS Revalidation Lookup Tool

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 91706)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002729175View full group profile
NameSpecialtyState
U R O L O G YOH
Nurse PractitionerCA
Internal MedicineCA
Internal MedicineCA
Internal Medicine, GastroenterologyCA
Physician AssistantCA
Emergency MedicineNC
O P H T H A L M O L O G YCA
Anesthesiology, Pain ManagementNH
Family Practice, Sports MedicineCA

Reviews

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Frequently asked questions

How do I look up JU-EN C THLICK by NPI?
Use NPI 1386878262 when you need to reference JU-EN C THLICK in forms, claims, or directories.
Is JU-EN C THLICK active in the national directory?
JU-EN C THLICK's public NPI profile is in an active state.
What kind of provider is JU-EN C THLICK?
The page reflects Gastroenterology Physician for JU-EN C THLICK. Clinical services aligned with this taxonomy classification.
Where does public data place JU-EN C THLICK?
The snapshot lists Baldwin Park, California for JU-EN C THLICK; download NPPES for the complete set.
How can I contact JU-EN C THLICK?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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