Thomas Earl Himelick, PA-C, MMSC
Individual provider Active NPI Physician Assistant · Pinehill, NM
NPI 1073840930 · NPPES record last updated Sep 16, 2020
Key facts
- NPI
- 1073840930
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA2002-0034 (NM)
- Practice address
- Bia Route 125
Pine Hill Health Center
Pinehill, NM 87357 - Phone
- (505) 775-3271
- NPI assigned
- Nov 12, 2009
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA2002-0034 | NM | Yes |
Addresses
Primary practice location
Bia Route 125
Pine Hill Health Center
Pinehill, NM 87357
Mailing address
HC 61 Box 5022
Ramah, NM 87321-9803
Phone (505) 783-4047
Other practice location 1
1217 Bonita St
Western NM Medical Group - Grants
Grants, NM 87020-2103
Phone (505) 287-2958
Other providers in Pinehill, NM
- Tamarah Lynn Boysel
- Jennifer John Charley
- Aislinn B Grover
- Perry D Guthrie Jr.
- Lula Kelhoyouma
- Natasha Starr Martinez
- Siamak Mollaei
- Ramah Navajo School Board, Inc.
- Ramah Navajo School Board, Inc.
All providers in Pinehill, NM · Physician Assistant in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.