Individual provider Active NPI

Thomas D Dea, PA-C

  • Physician Assistant
  • Spokane, WA
National Provider Identifier
1003888108
Registry record updated Dec 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10003775 Issued in WA
Practice address
5633 N Lidgerwood St
Spokane, WA 99208-1224
Phone
(509) 482-2460
NPI assigned
Feb 2, 2006
Last updated
Dec 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10003775 WA Primary

Addresses

Primary practice location

5633 N Lidgerwood St
Spokane, WA 99208-1224

Mailing address

910 N Washington St
Suite 209
Spokane, WA 99201-2202
Phone (509) 232-1173

Other identifiers 5

IdentifierTypeStateIssuer
000010157088OtherREGENCE BS OF IDAHO
0210988OtherWALABOR & INDUSTRIES
P00418396OtherRAIL ROAD MEDICARE
6767DEOtherWAASURIS NW HEALTH
8417271MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041028000274 WA Practitioner - Physician Assistant 7618939083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spokane Emergency Care Physicians PLLCGroup PAC ID 0143554600, 68 clinicians

Practice addresses (Care Compare)

12606 E Mission Ave
Spokane Valley, WA 99216-3421
Phone (509) 473-5177

800 W 5TH Ave
Spokane, WA 99204-2803
Phone (509) 473-7101

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA10003775WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Specialists of Spokane Past Accepting new patients
Providence Health & Services - Washington Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197072000000",
    "number": "1003888108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 N WASHINGTON ST",
            "address_2": "SUITE 209",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012202",
            "telephone_number": "509-232-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5633 N LIDGERWOOD ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992081224",
            "telephone_number": "509-482-2460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEA",
        "first_name": "THOMAS",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2007-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10003775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BS OF IDAHO",
            "identifier": "000010157088",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0210988",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00418396",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASURIS NW HEALTH",
            "identifier": "6767DE",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8417271",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.