Individual provider Active NPI

Thomas J Paluch, CRNA

  • Certified Registered Nurse Anesthetist
  • Tarboro, NC
National Provider Identifier
1104966951
Registry record updated Nov 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
034405 Issued in NC
Practice address
111 Hospital Dr
Tarboro, NC 27886-2011
Phone
(252) 641-7170
Fax
(252) 641-7373
NPI assigned
Feb 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 078681 NC
Certified Registered Nurse Anesthetist 367500000X 034405 NC Primary

Addresses

Primary practice location

111 Hospital Dr
Tarboro, NC 27886-2011

Mailing address

1015 Saint Andrew St
Tarboro, NC 27886-3842
Phone (252) 823-8944

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
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
078681NCMDRegistered Nurse
034405NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina Anesthesia Associates, PLLC Registered Nurse PastSince Jan 1, 2006 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384300800000",
    "number": "1104966951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 SAINT ANDREW ST",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278863842",
            "telephone_number": "252-823-8944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HOSPITAL DR",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278862011",
            "telephone_number": "252-641-7170",
            "fax_number": "252-641-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALUCH",
        "first_name": "THOMAS",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2013-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "078681",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "034405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.