MIKEY THANTERAPHONG – Nurse Practitioner, NPI 1437795333
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
16,360 NURSE PRACTITIONER in CA
Provider Addresses for MIKEY THANTERAPHONG
11550 INDIAN HILLS RD STE 371
MISSION HILLS, CA 913451252
Phone: (818) 365-1194
Type: Mailing
PO BOX 336
AGOURA HILLS, CA 913760336
Phone: (818) 835-7355
Type: Mailing
2845 COCHRAN ST STE B
SIMI VALLEY, CA 930657905
Phone: (818) 835-7355
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: 2021-10-27
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 |
|---|---|---|---|---|
| I20211027002125 | I | Nurse Practitioner | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 154 | 146 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 59 | 59 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 42 | 40 | $0 |
| 87811 | Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) | 30 | 28 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 21 | 21 | $0 |
Insurance plans in this area (ZIP 91345)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery, Vascular Surgery | CA | |
| Nurse Practitioner | CA | |
| Family Practice | AZ | |
| - | CA | |
| Internal Medicine | CA | |
| Physician Assistant | CA | |
| Physician Assistant | CA | |
| Physician Assistant | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA |
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