Thomas Gerald Depuydt, M.D.

Primary specialty

Sports Medicine (Preventive Medicine) PhysicianTaxonomy code 2083S0010X

License

MD00017432 Issued in WA

Practice address

12707 120TH Ave NE
Suite 203
Kirkland, WA 98034-7500

Phone

(425) 820-1221

Fax

(425) 821-9362

NPI assigned

Jul 1, 2006

Last updated

Sep 11, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1063441236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12707 120TH AVE NE",
            "address_2": "SUITE 203",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347500",
            "telephone_number": "425-820-1221",
            "fax_number": "425-821-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12707 120TH AVE NE",
            "address_2": "SUITE 203",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347500",
            "telephone_number": "425-820-1221",
            "fax_number": "425-821-9362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPUYDT",
        "first_name": "THOMAS",
        "middle_name": "GERALD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "WA",
            "license": "MD00017432",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "WA",
            "license": "MD00017432",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "WA",
            "license": "MD00017432",
            "primary": false
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "WA",
            "license": "MD00017432",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "WA",
            "license": "MD00017432",
            "primary": false
        },
        {
            "code": "2083S0010X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Sports Medicine",
            "state": "WA",
            "license": "MD00017432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evelyn A Dennison, M.D.
• Hannah C Dentry, RDN, CD
• Ronika Depoe
• Rebecca Deputy Crofoot, LMP
• Briauna Maureen Depuy
• Shanti Nichelle Der Blatter
• Diana Dericks
• Dermavita Medispa
• Dominic Desanto, DPT
• Jeremie M Descartes

• Sports Medicine (Preventive Medicine) Physician in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Sports Medicine (Preventive Medicine) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.