Individual provider Active NPI

Stephen Thom, MD

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1154360667
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD037634E Issued in PA
Practice address
3400 Spruce Street
Ground Silverstein BLDG
Philadelphia, PA 19104
Phone
(215) 662-6963
NPI assigned
Jun 6, 2006
Last updated
Feb 28, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD037634E PA Primary
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X MD037634E PA

Addresses

Primary practice location

3400 Spruce Street
Ground Silverstein BLDG
Philadelphia, PA 19104

Mailing address

3400 Spruce St.
Ground Silverstein Building
Philadelphia, PA 19104-4206
Phone (215) 662-7248

Other identifiers 1

IdentifierTypeStateIssuer
0010821540002MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130808000604 MD Practitioner - Emergency Medicine 1456488725 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD037634EPAMDUndersea and Hyperbaric Medicine (Preventive Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Emergency Medicine Associates, PA Emergency Medicine CurrentSince Jul 1, 2013 Accepting new patients
University of Maryland Midtown Health Inc CurrentSince Nov 13, 2017 Accepting new patients

Locations

105 Penn St
Baltimore, MD 21201
Phone (410) 328-2387

821 N Eutaw St
Baltimore, MD 21201
Phone (410) 225-9185

Interoperability endpoints

  • Direct secure messaging: sthom231835@direct.umm.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362009600000",
    "number": "1154360667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST.",
            "address_2": "GROUND SILVERSTEIN BUILDING",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-7248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "address_2": "GROUND SILVERSTEIN BLDG",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-6963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOM",
        "first_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2013-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD037634E",
            "primary": true
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "PA",
            "license": "MD037634E",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010821540002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.