Individual provider Active NPI

Thomas Andrew Luscomb

  • Anesthesiology Physician
  • Truckee, CA
National Provider Identifier
1053767459
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A168545 Issued in CA
Practice address
10121 Pine Ave
Truckee, CA 96161-4835
Phone
(530) 587-6011
NPI assigned
May 4, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A168545 CA Primary

Addresses

Primary practice location

10121 Pine Ave
Truckee, CA 96161-4835

Mailing address

10050 Bridge St # 470
Truckee, CA 96161-0212
Phone (405) 569-0752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20221117002684 MT Practitioner - Anesthesiology 0143513267 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Oklahoma College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Missoula Bone and Joint LLCGroup PAC ID 3870583990, 57 clinicians

Practice addresses (Care Compare)

2360 Mullan Rd
Suite C
Missoula, MT 59808-1811
Phone (406) 721-4436

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A168545CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Missoula Bone & Joint, LLC CurrentSince Jul 1, 2025 Accepting new patients
Gallatin Valley Anesthesia Associates PC Anesthesiology CurrentSince Oct 20, 2022 Accepting new patients
Intercity Radiology, PC Past Accepting new patients

Locations

2800 10th Ave N
Billings, MT 59101
Phone (406) 248-3290

925 Highland Blvd
Ste 1180
Bozeman, MT 59715
Phone (406) 582-4963

915 Highland Blvd
Bozeman, MT 59715
Phone (406) 414-1720

2360 Mullan Rd
Ste B
Missoula, MT 59808
Phone (406) 542-9695

2360 Mullan Rd
Ste C
Missoula, MT 59808
Phone (406) 542-9695

Interoperability endpoints

  • FHIR API: https://mbnj.mmi.prod.fhir.ema-api.com/fhir/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1053767459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10050 BRIDGE ST # 470",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961610212",
            "telephone_number": "405-569-0752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10121 PINE AVE",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961614835",
            "telephone_number": "530-587-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSCOMB",
        "first_name": "THOMAS",
        "middle_name": "ANDREW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-04",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A168545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Truckee, CA

Sources for this page

Verify at the official NPI Registry.