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BLAICHIA THAO
NPI 1508553900
Student in an Organized Health Care Education/Training Program in Warren, MI

Active since April 18, 2023PECOS EnrolledAccepts Medicare Assignment
11900 E 12 MILE RD STE 102, WARREN, MI 48093(586) 582-6630 Get Directions Write a Review

NPPES record last updated: April 28, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Blaichia Thao NPPES

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

BLAICHIA THAO (NPI 1508553900) is an individual student in an organized health care education/training program in Warren, Michigan and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS and is a graduate of Des Moines University Of Osteopathic Medicine And Health Sciences (2023).

NPPES Registry Identity

NPI1508553900
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameBLAICHIA THAO
Location Address11900 E 12 MILE RD STE 102Warren, MI 48093-3487
Mailing Address11900 E 12 Mile Rd Ste 102Warren, MI 48093-3487
Phone(586) 582-6630
Sole ProprietorYes
Medical School CMSDes Moines University Of Osteopathic Medicine And Health SciencesGraduated 2023
Enumeration DateApril 18, 2023
Last NPPES UpdateApril 28, 2023
NPPES CertifiedApril 28, 2023
✔ NPI 1508553900 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
11900 E 12 MILE RD STE 102, Warren, MI 48093
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cox HealthPlans.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Blaichia Thao 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 ID2769840149
PECOS Enrollment IDI20260810003455
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.

Medicare Billing Reassignment

Medicare enrollment records show Blaichia Thao reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Foot Doctors, P.C.
659 mi
Foot Surgery
929 E MONTCLAIR STUITE 100
Springfield, MO 65807
  • Reassigned Medicare billing, Missouri enrollment
  • 3 clinicians in this Medicare group
NPI 1336368745 (417) 883-1881

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 13

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

YONG KOH
Student in an Organized Health Care Education/Training Program
11900 E 12 MILE RD STE 102
WARREN, MI 48093
Macomb County (586) 573-7470
CHRISTOPHER WOMAC
Student in an Organized Health Care Education/Training Program
11900 E 12 MILE RD STE 102
WARREN, MI 48093
Macomb County (586) 573-7470
NATALYA VORONOVICH
Student in an Organized Health Care Education/Training Program
11900 E 12 MILE RD STE 102
WARREN, MI 48093
Macomb County (586) 573-7470
AHMAD FIRAS ALLAHHAM
Student in an Organized Health Care Education/Training Program
11900 E 12 MILE RD STE 102
WARREN, MI 48093
Macomb County (313) 423-1105
DR. WISSAM DIMACHK DPM
Podiatrist (Foot & Ankle Surgery)
11900 E 12 MILE RD STE 102
WARREN, MI 48093
Macomb County (586) 573-7470
HENNA ATA DPM
Student in an Organized Health Care Education/Training Program
11900 E 12 MILE RD STE 102
WARREN, MI 48093
Macomb County (586) 573-7470
TAHA MAHMOOD DPM
Student in an Organized Health Care Education/Training Program
11900 E 12 MILE RD STE 102
WARREN, MI 48093
Macomb County (586) 573-7470
HAFSA ABID DPM
Student in an Organized Health Care Education/Training Program
11900 E 12 MILE RD STE 102
WARREN, MI 48093
Macomb County (586) 573-7470

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blaichia Thao's NPI number?

The NPI number for Blaichia Thao is 1508553900. It was assigned to this individual provider in the NPPES registry on April 18, 2023.

Where is Blaichia Thao located?

Blaichia Thao practices at 11900 E 12 Mile Rd Ste 102, Warren, MI 48093. The listed phone number is (586) 582-6630.

What is Blaichia Thao's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Blaichia Thao enrolled in Medicare?

Yes. Blaichia Thao is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Blaichia Thao's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Blaichia Thao reassigns Medicare benefits to Foot Doctors, P.C. (Springfield, MO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Blaichia Thao's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Blaichia Thao accept?

Health plans from Cox HealthPlans list Blaichia Thao as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Blaichia Thao was last updated on April 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.