Individual provider Active NPI

Jay R Thomas, MD

  • Internal Medicine Physician
  • South Pasadena, CA
National Provider Identifier
1013092980
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A55197 Issued in CA
Practice address
1624 Bank St
South Pasadena, CA 91030-3830
Phone
(626) 487-0036
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X A55197 CA
Internal Medicine Physician 207R00000X A55197 CA Primary

Addresses

Primary practice location

1624 Bank St
South Pasadena, CA 91030-3830

Mailing address

1624 Bank St
South Pasadena, CA 91030-3830
Phone (626) 487-0036

Other identifiers 1

IdentifierTypeStateIssuer
00A551970MedicaidCA

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
I20070927000786 CA Practitioner - Internal MedicinePractitioner - Interventional Pain ManagementPractitioner - Hospice/Palliative Care 5799870358 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 30, 2013 Accepting new patients
Healthcare Partners Affiliates Medical Group Internal Medicine Current Accepting new patients
City of Hope Medical Foundation CurrentSince Jun 1, 2011 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 30, 2013 Accepting new patients
California Cancer Specialists Medical Group Inc Past Accepting new patients

Locations

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

1500 Duarte Rd
Bldg 149
Duarte, CA 91010
Phone (626) 359-8111

1500 Duarte Rd
Duarte, CA 91010
Phone (626) 359-8111

601 Torrance Blvd
#1182
Redondo Beach, CA 90277

209 Fair Oaks Ave
South Pasadena, CA 91030
Phone (626) 359-8111

23861 McBean Pkwy
Ste B14
Valencia, CA 91355
Phone (661) 799-1999

Interoperability endpoints

  • Direct secure messaging: jthomas189663@cityofhope.direct-ci.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1013092980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 BANK ST",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910303830",
            "telephone_number": "626-487-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 BANK ST",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910303830",
            "telephone_number": "626-487-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JAY",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "CA",
            "license": "A55197",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A55197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A551970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Pasadena, CA

Sources for this page

Verify at the official NPI Registry.