Active NPI
Mark S Thomas, MD
- Family Medicine Physician
- Saint Paul, MN
National Provider Identifier
1093775686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35858
- Practice address
- 153 Cesar Chavez St
Saint Paul, MN 55107-2226 - Phone
- (651) 602-7500
- Fax
- (651) 602-7580
- NPI assigned
- Mar 27, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35858 | MN | Primary |
Addresses
Primary practice location
153 Cesar Chavez St
Saint Paul, MN 55107-2226
Mailing address
153 Cesar Chavez St
Saint Paul, MN 55107-2226
Phone (651) 602-7500
Other practice location 1
600 Pemberton Browns-Mills Rd.
Pemberton, NJ 08068-0248
Phone (609) 894-1100
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HP17266 | Other | MN | HEALTH PARTNERS |
| 923877800 | Medicaid | MN | |
| 01-16933 | Other | MN | MEDICA |
| 105424 | Other | MN | UCARE |
| NA9021019261 | Other | MN | PREFERRED ONE |
| 2F800TH | Other | MN | BCBS |
| 0553794 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Side Community Health Services, Inc. | Current | Accepting new patients |
Locations
153 Cesar Chavez St
West Saint Paul, MN 55107
Phone (651) 222-1816
Organizations & group practices 1
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.
-
- Federally Qualified Health Center (FQHC)
- Saint Paul, MN
- NPI 1821149964
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537315200000",
"number": "1093775686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "153 CESAR CHAVEZ ST",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551072226",
"telephone_number": "651-602-7500",
"fax_number": "651-602-7580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "153 CESAR CHAVEZ ST",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551072226",
"telephone_number": "651-602-7500",
"fax_number": "651-602-7580"
}
],
"practiceLocations": [
{
"address_1": "600 Pemberton Browns-Mills Rd.",
"address_purpose": "LOCATION",
"city": "Pemberton",
"state": "NJ",
"postal_code": "080680248",
"country_code": "US",
"telephone_number": "609-894-1100",
"fax_number": "609-894-1110",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THOMAS",
"first_name": "MARK",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-27",
"last_updated": "2018-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "35858",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP17266",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "923877800",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "01-16933",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "105424",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "NA9021019261",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "2F800TH",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0553794",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.