DR. SEAN C LAI M.D,
NPI 1396739470
Specialist in Santa Monica, CA

Active since September 06, 2005PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
2001 SANTA MONICA BLVD, SUITE 1286W, SANTA MONICA, CA 90404(310) 453-0553(310) 943-2776 Get Directions Write a Review

NPPES record last updated: June 17, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Sean C Lai M.d, NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SEAN C LAI M.D, (NPI 1396739470) is an individual specialist in Santa Monica, California and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS and is a graduate of University Of Washington School Of Medicine (1976).

NPPES Registry Identity

NPI1396739470
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameDR. SEAN C LAICredential: M.D,
Location Address2001 SANTA MONICA BLVD, SUITE 1286WSanta Monica, CA 90404-2102
Mailing Address2001 Santa Monica Blvd, Suite 1286wSanta Monica, CA 90404-2102 · (310) 453-0553 · Fax (310) 943-2776
Fax(310) 943-2776
Sole ProprietorYes
Medical School CMSUniversity Of Washington School Of MedicineGraduated 1976
Enumeration DateSeptember 6, 2005
Last NPPES UpdateJune 17, 2015
NPI 1396739470 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

2001 SANTA MONICA BLVD, Santa Monica, CA 90404

Other Identifiers 2

Medicare UPIND33319CA
MedicaidG40912CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Sean C Lai M.d, is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2264424001
PECOS Enrollment IDI20040331001729
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 15

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Follow-up hospital inpatient care per day, typically 25 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
2,790 services206 patients
Established patient office or other outpatient visit, 20-29 minutes 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
268 services150 patients
Initial hospital inpatient care per day, typically 70 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
232 services190 patients
Established patient office or other outpatient visit, 30-39 minutes 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
202 services117 patients
Stool analysis for blood, by peroxidase activity 82272
A stool analysis for blood, by peroxidase activity, is a test to detect blood in your stool. This test helps identify bleeding in the digestive tract. It involves collecting a stool sample, which is then checked for the presence of blood using a chemical reaction.
131 services92 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
112 services108 patients

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality100
Improvement Activities40
Cost97.97

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
3 suppliers13 claims39 services$6.27 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
2 suppliers14 claims21 services$17.08 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

MIPS Quality Measures

The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.

Quality Measure Performance Number of Patients
Advance Care Plan 100% 179
Colorectal Cancer Screening 83% 126
Controlling High Blood Pressure 79% 78
Diabetes Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy - Neurological Evaluation 100% 41
Documentation of Current Medications in the Medical Record 100% 602
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 100% 250
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 100% 164
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 100% 164
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling 100% 164
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling 100% 164
Screening for Osteoporosis for Women Aged 65-85 Years of Age 10% 58
Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older 100% 83

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Podiatrist (Foot & Ankle Surgery)
2001 SANTA MONICA BLVD, STE 983
SANTA MONICA, CA 90404
Internal Medicine (Gastroenterology)
2001 SANTA MONICA BLVD, SUITE 1170
SANTA MONICA, CA 90404
Family Medicine
2001 SANTA MONICA BLVD, #888 W
SANTA MONICA, CA 90404
Surgery
2001 SANTA MONICA BLVD, 460 W
SANTA MONICA, CA 90404
Dermatology
2001 SANTA MONICA BLVD, 990W
SANTA MONICA, CA 90404
Dermatology
2001 SANTA MONICA BLVD, 990W
SANTA MONICA, CA 90404
Physician Assistant (Surgical)
2001 SANTA MONICA BLVD, 990W
SANTA MONICA, CA 90404
Dermatology
2001 SANTA MONICA BLVD, 990W
SANTA MONICA, CA 90404

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1396739470, enumerated as an "individual" on September 06, 2005.

The provider is located at 2001 SANTA MONICA BLVD SUITE 1286W SANTA MONICA, CA 90404 and the phone number is (310) 453-0553.

Specialist with taxonomy code 174400000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.