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Active NPI 1114699428 Individual Practitioner Female Practitioner

Lili Tha

Physician Assistant • Frederick, MD

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Lili Tha is a certified Physician Assistant practicing in Frederick, MD. With approximately 4 years of clinical experience since completing medical education in 2022, Lili Tha delivers high-quality medical care to the local community at 300 BALLENGER CENTER DR.

Lili Tha is affiliated with Minuteclinic Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include administration of influenza virus vaccine, admn sarscov2 vacc 1 dose, sarscv2 vac 30mcg trs-suc im. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

300 Ballenger Center Dr

Frederick, MD 217037096

Telephone 8663892727
Associated Practice Facility / Clinic
🏢 Maryland Cvs Pharmacy Llc Facility NPI 1679676498

Medicare Profile & Education

Medical School

Other

Graduation Year

2022

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Frederick, MD

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
4 Yrs -7.9 yrs vs City Avg
City Avg: 11.9 Yrs
State Avg: 11.8 Yrs
Regional Practice Density
107 Specialists

Practicing in Frederick, MD (3255 Statewide)

Telehealth Adoption Rate
23.4% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
42.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Tha (4 Years) 4 Yrs
Frederick Specialty Average (11.9 Years) 11.9 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
G0008 Administration of influenza virus vaccine
34 34 $52.94 $32.30
90480 Admn sarscov2 vacc 1 dose
33 33 $56.97 $41.55
91320 Sarscv2 vac 30mcg trs-suc im
33 33 $212.68 $143.21
99213 Established patient office or other outpatient visit, typically 15 minutes
33 32 $143.71 $77.20
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus
31 26 $120.00 $34.62
90662 Influenza vaccine split virus, preservative free
29 29 $124.78 $81.48
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
22 22 $176.94 $94.89
87651 Detection test for Strep (Streptococcus, group A)
11 11 $54.81 $34.39

Medical Specialties & State Licenses

CMS Verified: 2023-01-19
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License MD C0008722

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

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.

Hospital & Practice Group Affiliations

Minuteclinic Llc

3350 Worthington Blvd, Frederick, MD 217047025

Phone: 8663892727

Minuteclinic Llc

1 Cvs Dr, Woonsocket, RI 028956146

Minuteclinic Llc

10095 Ward Rd, Dunkirk, MD 207542731

Phone: 8663892727

Minuteclinic Llc

2601 Riva Rd, Annapolis, MD 214017304

Phone: 8663892727

Minuteclinic Llc

300 Ballenger Ctr Dr, Frederick, MD 217037096

Phone: 8663892727

Minuteclinic Llc

8032 C Liberty Rd, Frederick, MD 217013239

Phone: 8663892727

Secondary Practice Locations

822 Apache Ct

Frederick, MD 217014690

Phone: 2405298245

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Nicole Wagschal , MSN APRN

Nurse Practitioner - Family

NPI 1003013525

MSNAPRN

Shelly Gallini , PA-C

Physician Assistant

NPI 1003089210

Physician Assistant (Certified)

Dr. Lilia Pino , PhD, ARNP

Nurse Practitioner - Family

NPI 1003094855

Doctor of Philosophy (Ph.D.), Advanced Registered Nurse Practitioner

Maria Gagliano , FNP

Nurse Practitioner - Family

NPI 1003160532

Family Nurse Practitioner

Jennifer Price , APRN

Nurse Practitioner - Family

NPI 1003185570

Advanced Practice Registered Nurse

Megan Lottes , NP-C

Nurse Practitioner - Family

NPI 1003196965

Nurse Practitioner (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location January 19, 2023

Registered at 300 BALLENGER CENTER DR, FREDERICK, MD 217037096 (Tel: 8663892727)

📍
Updated Business Mailing Address January 19, 2023

Registered at 300 BALLENGER CENTER DR, FREDERICK, MD 217037096 (Tel: 8663892727)

NPI Profile Active October 05, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location October 05, 2021

Registered at 822 APACHE CT, FREDERICK, MD 217014690 (Tel: 2405298245)

📍
Updated Business Mailing Address October 05, 2021

Registered at 822 APACHE CT, FREDERICK, MD 217014690 (Tel: 2405298245)

👤
Provider Name / Credentials Updated October 05, 2021

Recorded as LILI THA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 05, 2021

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration October 05, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114699428
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 05, 2021
Last Update: January 19, 2023
Sole Proprietor: Yes

Mailing Address

300 Ballenger Center Dr

Frederick, MD 217037096

Phone: 8663892727

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.