Individual provider Active NPI

Donna Ruth Thompson, MD

  • Family Medicine Physician
  • San Bernardino, CA
National Provider Identifier
1033189568
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G67144 Issued in CA
Practice address
1700 North Waterman Ave
San Bernardino, CA 92404-5105
Phone
(909) 883-8611
Fax
(909) 886-1798
NPI assigned
Jan 26, 2006
Last updated
Mar 11, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G67144 CA Primary

Addresses

Primary practice location

1700 North Waterman Ave
San Bernardino, CA 92404-5105

Mailing address

1700 North Waterman Ave
San Bernardino, CA 92404-5105
Phone (909) 883-8611

Other identifiers 1

IdentifierTypeStateIssuer
00G671440MedicaidCA

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
I20080716000702 CA Practitioner - Family Practice 6709959216 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, San Francisco School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaver Medical Group P CGroup PAC ID 0547164295, 251 clinicians

Practice addresses (Care Compare)

145 Thunder Dr
Vista, CA 92083-6010
Phone (760) 941-9002

1700 N Waterman Ave
San Bernardino, CA 92404-5115
Phone (909) 883-8611

2 W Fern Ave
Redlands, CA 92373-5916
Phone (909) 793-3311

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G67144CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Redlands Family Physicians Medical Associates, Inc. Family Medicine CurrentSince Sep 1, 2019 Accepting new patients
Cassidy Medical Group Inc. Current Accepting new patients
Beaver Medical Group P C CurrentSince Jul 21, 2024 Accepting new patients
Centers for Family Medicine GP Family Medicine CurrentSince Jul 21, 2024 Accepting new patients
Beaver Medical Group P C Family Medicine CurrentSince Jul 21, 2024 Accepting new patients
Healthcare Partners Affiliates Medical Group Family Medicine CurrentSince Jan 1, 2024 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Redlands Family Practice Medical Group Inc. Family Medicine CurrentSince Sep 1, 2019 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

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

4910 Airport Plaza Dr
Ste 210
Long Beach, CA 90815
Phone (562) 421-3727

3460 Katella Ave
Los Alamitos, CA 90720
Phone (310) 594-6599

1520 Barton Rd
Redlands, CA 92373
Phone (909) 793-3208

2 W Fern Ave
Redlands, CA 92373
Phone (909) 786-0725

2 W Fern Ave
#1112
Redlands, CA 92373

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

145 Thunder Dr
Vista, CA 92083
Phone (760) 630-5487

Interoperability endpoints

  • Direct secure messaging: dthompson22054@epiclp.direct-ci.com

Organizations & group practices 8

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205193600000",
    "number": "1033189568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NORTH WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045105",
            "telephone_number": "909-883-8611",
            "fax_number": "909-886-1798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 NORTH WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045105",
            "telephone_number": "909-883-8611",
            "fax_number": "909-886-1798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "DONNA",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2008-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G67144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G671440",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.