Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lili Tha

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1114699428

Lili Tha is a Physician Assistant in Frederick, Maryland. Qualified in 2022, 4 years ago. Practices with Minuteclinic LLC, a 574-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Maryland.

Years since qualifying
4
Licensed in
MD
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

300 Ballenger Center Dr
Frederick, MD 21703-7096
Phone: (866) 389-2727
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 822 Apache Ct, Frederick, MD 21701-4690 — (240) 529-8245

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence C0008722 (MD)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1114699428
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 5, 2021
Last updated in NPPESJanuary 19, 2023
Certification dateJanuary 19, 2023
Mailing address300 Ballenger Center Dr, Frederick, MD 21703-7096

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Minuteclinic Llc — 574 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Frederick