Individual provider Active NPI

Richard E Thistle Jr., M.D

  • Emergency Medicine Physician
  • Madera, CA
National Provider Identifier
1043220502
Registry record updated Jul 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
C41839 Issued in CA
Practice address
1250 E Almond Ave
Madera, CA 93637-5606
Phone
(559) 675-5555
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X C41839 CA Primary

Addresses

Primary practice location

1250 E Almond Ave
Madera, CA 93637-5606

Mailing address

2100 Powell St
Suite 900
Emeryville, CA 94608-1826
Phone (510) 350-2600

Other identifiers 1

IdentifierTypeStateIssuer
00C418390MedicaidCA

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
I20041227000704 CA Practitioner - Emergency MedicinePractitioner - General Practice 9931167749 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C41839CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America-California Emergency Medicine CurrentSince Oct 1, 1996 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Oct 1, 1996 Accepting new patients
Anaheim Global Medical Center, Inc Past Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

1401 Garces Hwy
Delano, CA 93215
Phone (661) 381-7545

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1025 N Douty St
Hanford, CA 93230
Phone (559) 537-0170

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

1250 E Almond Ave
Madera, CA 93637
Phone (559) 675-5501

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

372 W Cypress Ave
Reedley, CA 93654
Phone (559) 391-3110

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

1141 Rose Ave
Selma, CA 93662
Phone (559) 790-2800

Interoperability endpoints

  • Direct secure messaging: richard.thistle.jr.1@20515.direct.athenahealth.com

Organizations & group practices 4

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216252800000",
    "number": "1043220502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "SUITE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2600",
            "fax_number": "510-879-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E ALMOND AVE",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936375606",
            "telephone_number": "559-675-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THISTLE",
        "first_name": "RICHARD",
        "middle_name": "E",
        "name_suffix": "Jr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2008-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "C41839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C418390",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

Verify at the official NPI Registry.