Active NPI
Tyler Jeffrey Thomas, D.M.D.
- Prosthodontics
- Carmel, IN
National Provider Identifier
1073929832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 12012667A
- Practice address
- 370 Medical Dr Ste B
Carmel, IN 46032-2971 - Phone
- (317) 844-4155
- NPI assigned
- Jul 1, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Prosthodontics | 1223P0700X | 12012667A | IN | Primary |
Addresses
Primary practice location
370 Medical Dr Ste B
Carmel, IN 46032-2971
Mailing address
3107 Wildman LN
Carmel, IN 46032-8757
Phone (970) 231-1896
Other practice location 1
263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160224000005 | CT | Order and Referring Only - Other (Physician) | 3971808312 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12012667A | IN | MD | Prosthodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indiana Restorative Dentistry PC | Prosthodontics | Past | Accepting new patients |
| Midwest Prosthodontics LLC | Prosthodontics | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Prosthodontics
- Carmel, IN
- NPI 1942709118
-
- Prosthodontics
- Carmel, IN
- NPI 1891916169
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1073929832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3107 WILDMAN LN",
"city": "CARMEL",
"state": "IN",
"postal_code": "460328757",
"telephone_number": "970-231-1896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "370 MEDICAL DR STE B",
"city": "CARMEL",
"state": "IN",
"postal_code": "460322971",
"telephone_number": "317-844-4155"
}
],
"practiceLocations": [
{
"address_1": "263 Farmington Ave",
"address_purpose": "LOCATION",
"city": "Farmington",
"state": "CT",
"postal_code": "060300001",
"country_code": "US",
"telephone_number": "860-679-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THOMAS",
"first_name": "TYLER",
"middle_name": "JEFFREY",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-01",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "IN",
"license": "12012667A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Carmel, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.