NPIMap

Individual provider Active NPI

Thomas Jacob Seales, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Fort Walton Beach, FL
National Provider Identifier
1104184951
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
131396 Issued in FL
Practice address
1034 Mar Walt Dr Unit 100
Fort Walton Beach, FL 32547-6637
Phone
(850) 863-2153
NPI assigned
Apr 30, 2012
Last updated
Jan 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 131396 FL Primary

Addresses

Primary practice location

1034 Mar Walt Dr Unit 100
Fort Walton Beach, FL 32547-6637

Mailing address

PO Box 740923
Atlanta, GA 30374-0923
Phone (850) 863-2153

Other identifiers 3

IdentifierTypeStateIssuer
14092927OtherFLCAQH
02171200MedicaidFL
ON9E7OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170907002840 FL Practitioner - Orthopedic Surgery 1456597087 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Alabama School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

1034 Mar Walt Dr
Fort Walton Beach, FL 32547-6645
Phone (850) 344-1646

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.79 of 100Reported as group
Quality
64.42
Promoting interoperability
100
Improvement activities
40
Cost
74.88

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement77
Knee replacement74
Lower limb (leg) arthroscopy (minimally invasive joint repair)19
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
131396FLMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Associates PA Adult Reconstructive Orthopaedic Surgery CurrentSince Sep 12, 2018 Accepting new patients
Orthopaedic Associates, PA Adult Reconstructive Orthopaedic Surgery CurrentSince Sep 12, 2018 Accepting new patients
North Florida Surgeons, PA CurrentSince May 19, 2024 Accepting new patients
North Florida Surgeons, PA CurrentSince May 19, 2024 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Orthopaedic Associates PA Adult Reconstructive Orthopaedic Surgery Past Accepting new patients
Surgical Specialists ASC, LLC PastSince Dec 20, 2021 Accepting new patients

Locations

5300 S Ferdon Blvd
Crestview, FL 32536
Phone (850) 344-1646

36468 Emerald Coast Pkwy
Ste 1101
Destin, FL 32541
Phone (850) 290-2154

36474C Emerald Coast Pkwy
Ste 3101
Destin, FL 32541
Phone (850) 344-1646

1340 S 18th St
Ste 104
Fernandina Beach, FL 32034
Phone (904) 277-3277

1034 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 344-1646

1034 Mar Walt Dr
Unit 100
Ft Walton Bch, FL 32547
Phone (850) 315-9210

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

554 Twin Cities Blvd
Ste D
Niceville, FL 32578
Phone (850) 315-9210

Interoperability endpoints

  • Direct secure messaging: thomas.seales.1@9109.direct.athenahealth.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1104184951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740923",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740923",
            "telephone_number": "850-863-2153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 MAR WALT DR UNIT 100",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476637",
            "telephone_number": "850-863-2153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEALES",
        "first_name": "THOMAS",
        "middle_name": "JACOB",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-30",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "FL",
            "license": "131396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14092927",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02171200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "ON9E7",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.