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DR. THAO JACQUELINE THI MAI O.D.
NPI 1720537319
Optometrist in San Jose, CA

Active since September 24, 2016PECOS Enrolled
2180 TULLY RD, SAN JOSE, CA 95122(408) 239-1168 Get Directions Write a Review

NPPES record last updated: September 24, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Thao Jacqueline Thi Mai O.d. NPPES

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

DR. THAO JACQUELINE THI MAI O.D. (NPI 1720537319) is an individual optometrist in San Jose, California, licensed in California (OPT33573-TLG) and active in the NPI registry since September 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720537319
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameDR. THAO JACQUELINE THI MAICredential: O.D.
Location Address2180 TULLY RDSan Jose, CA 95122-1345
Mailing Address2180 Tully RdSan Jose, CA 95122-1345 · (408) 239-1168
Phone(408) 239-1168
Sole ProprietorYes
Enumeration DateSeptember 24, 2016
✔ NPI 1720537319 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in CA · OPT33573-TLG
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
2180 TULLY RD, San Jose, CA 95122
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Thao Jacqueline Thi Mai O.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Thao Jacqueline Mai reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Dr. Khanh Bui, O.D., P.C.
1.7 mi
Optometrist
1013 E CAPITOL EXPY
San Jose, CA 95121
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: Dr Khanh Bui Od PC
  • 4 clinicians in this Medicare group
NPI 1932382736 (408) 281-1311

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95122 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$156.67 typical visit price
range $70.37 – $206.04
Typical copayment $39.16 (range $17.59 – $51.51)
Most-billed visit code 99204
Established Patient
$86.56 typical visit price
range $23.96 – $169.60
Typical copayment $21.64 (range $5.99 – $42.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

MR. STEVEN K JA OD
Optometrist
2180 TULLY RD
SAN JOSE, CA 95122
Santa Clara County (408) 235-1167

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 Thao Jacqueline Mai's NPI number?

The NPI number for Thao Jacqueline Mai is 1720537319. It was assigned to this individual provider in the NPPES registry on September 24, 2016.

Where is Thao Jacqueline Mai located?

Thao Jacqueline Mai practices at 2180 Tully Rd, San Jose, CA 95122. The listed phone number is (408) 239-1168.

What is Thao Jacqueline Mai's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Thao Jacqueline Mai enrolled in Medicare?

Yes. Thao Jacqueline Mai is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Thao Jacqueline Mai's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Thao Jacqueline Mai reassigns Medicare benefits to Dr. Khanh Bui, O.D., P.C. (San Jose, CA). 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 Thao Jacqueline Mai's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Thao Jacqueline Mai was last updated on September 24, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.