Individual provider Active NPI

Thomas J Nuckton, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Santa Rosa, CA
National Provider Identifier
1003902834
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
G83871 Issued in CA
Practice address
3325 Chanate Rd
Santa Rosa, CA 95404-1707
Phone
(415) 596-1685
Fax
(415) 600-1753
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X CC6838711 CA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X G83871 CA Primary

Addresses

Primary practice location

3325 Chanate Rd
Santa Rosa, CA 95404-1707

Mailing address

6 Locksley Ave Apt 8J
San Francisco, CA 94122-3822
Phone (415) 596-1685

Other identifiers 1

IdentifierTypeStateIssuer
00G838711MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040323001950 CA Practitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 5496646820 Reassigns benefits to 2 organizations
Practice locations: Castro Valley, CA

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
R Franklin University of Med & Sci/Chicago Medical School, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Intensivists PC 112 clinicians

Practice addresses (Care Compare)

30 Mark W Springs Rd
Santa Rosa, CA 95403-1436
Phone (707) 576-4000

Hospital & facility affiliations

  • Sutter Santa Rosa Regional Hospital Hospital, Santa Rosa, CA, CCN 050291

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
CC6838711CAMDSpecialist
G83871CAMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Intensivists PC Critical Care Medicine Current Accepting new patients
Cep America - Intensivists PC Critical Care Medicine CurrentSince Feb 1, 2025 Accepting new patients
Inpatient Specialists of California, PC CurrentSince Dec 1, 2022 Accepting new patients
Cep America - Intensivists PC Critical Care Medicine CurrentSince Feb 1, 2025 Accepting new patients
Inpatient Consultants of California, Inc. Past Accepting new patients

Locations

20103 Lake Chabot Rd
Hayward, CA 94546
Phone (510) 537-1234

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2825 Capitol Ave
Sacramento, CA 95816
Phone (916) 887-0000

450 Stanyan St
San Francisco, CA 94117
Phone (415) 668-1000

30 Mark West Springs Rd
Santa Rosa, CA 95403
Phone (707) 576-4000

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

Organizations & group practices 6

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

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1003902834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 LOCKSLEY AVE APT 8J",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941223822",
            "telephone_number": "415-596-1685",
            "fax_number": "415-600-1753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 CHANATE RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954041707",
            "telephone_number": "415-596-1685",
            "fax_number": "415-600-1753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUCKTON",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "CC6838711",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "G83871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G838711",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.