Jai Thao, EDD is a medicare enrolled "Psychologist" provider in San Francisco, California. His current practice location is
2 Embarcadero Ctr Lbby Level, San Francisco, California. You can reach out to his office (for appointments etc.) via phone at
(888) 663-6331.
Jai Thao is licensed to practice in California (license number PSY35001) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1700267721.
Healthcare Provider's Profile
| Full Name | Jai Thao |
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| Gender | Male |
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| Speciality | Psychologist |
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| Location | 2 Embarcadero Ctr Lbby Level, San Francisco, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1700267721
- Provider Enumeration Date: 06/16/2015
- Last Update Date: 07/07/2025
Medicare PECOS Information:
- PECOS PAC ID: 5890145890
- Enrollment ID: I20250429003809
Medical Identifiers
Medical identifiers for Jai Thao such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1700267721 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | PSB94024755 (California) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | (California) | Secondary |
| 103T00000X | Psychologist | PSY35001 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jai Thao allows following entities to bill medicare on his behalf.
| Entity Name | Permanente Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073606299
PECOS PAC ID: 8921910225
Enrollment ID: O20031104000710 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jai Thao is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jai Thao, EDD
1 Embarcadero Ctr Ste 1900,
San Francisco, CA 94111-3723
Ph: (415) 658-6791 | Jai Thao, EDD
2 Embarcadero Ctr Lbby Level,
San Francisco, CA 94111-3823
Ph: (888) 663-6331 |
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