Individual provider Active NPI

Vincent J Thompson III, M.D.

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1174526180
Registry record updated Oct 29, 2018
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(4) exclusion effective Aug 20, 2024.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD426812 Issued in PA
Practice address
2020 Penrose Avenue
Suite A1
Philadelphia, PA 19145
Phone
(267) 519-0518
Fax
(267) 886-9761
NPI assigned
May 23, 2005
Last updated
Oct 29, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD426812 PA Primary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X XT4563777 PA

Addresses

Primary practice location

2020 Penrose Avenue
Suite A1
Philadelphia, PA 19145

Mailing address

2020 Penrose Avenue
Suite A1
Philadelphia, PA 19145
Phone (267) 519-0518

Other identifiers 1

IdentifierTypeStateIssuer
223613YHRNOtherMEDICARE PTAN

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD426812PAMDFamily Medicine Physician
XT4563777PAMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family and Urgent Care Center, Inc. Family Medicine Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Medexpress Urgent Care, PC - Monaca Past Accepting new patients

Organizations & group practices 3

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": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540771200000",
    "number": "1174526180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 PENROSE AVENUE",
            "address_2": "SUITE A1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19145",
            "telephone_number": "267-519-0518",
            "fax_number": "267-886-9761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 PENROSE AVENUE",
            "address_2": "SUITE A1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19145",
            "telephone_number": "267-519-0518",
            "fax_number": "267-886-9761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "VINCENT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2018-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD426812",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "PA",
            "license": "XT4563777",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "223613YHRN",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.