Individual provider Active NPI

Thomas Joseph Rydz, M.D.

  • Surgery Physician
  • Eureka, CA
National Provider Identifier
1184781536
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G71695 Issued in CA
Practice address
2321 Harrison Ave
Eureka, CA 95501-3216
Phone
(707) 445-3660
Fax
(707) 476-8431
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G71695 CA Primary

Addresses

Primary practice location

2321 Harrison Ave
Eureka, CA 95501-3216

Mailing address

2321 Harrison Ave
Eureka, CA 95501-3216
Phone (707) 445-3660

Other identifiers 1

IdentifierTypeStateIssuer
00G716950MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address trydz1658232@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20080614000067 CA Practitioner - General SurgeryPractitioner - Thoracic SurgeryPractitioner - Vascular Surgery 9032280375 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Thoracic Surgery, Vascular Surgery
Education
University of California, Geffen School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 546-3210

200 W Ctr St Promenade
Anaheim, CA 92805-3960

2700 Dolbeer St
Eureka, CA 95501-4736
Phone (707) 445-8121

2710 Dolbeer St
Eureka, CA 95501-4736
Phone (707) 267-2060

2752 Harrison Ave
Eureka, CA 95501-4738

3300 Renner Dr
Fortuna, CA 95540-3120
Phone (707) 725-3361

500 Doyle Park Dr
Santa Rosa, CA 95405-4559

Hospital & facility affiliations

  • Providence Redwood Memorial Hospital Hospital, Fortuna, CA, CCN 051318
  • Providence St Joseph Hospital Hospital, Eureka, CA, CCN 050006

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy128
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux94
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G71695CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Coast Surgical Specialists Surgery CurrentSince Jan 1, 1998 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Jun 27, 2016 Accepting new patients
Providence Medical Foundation Surgery CurrentSince Jun 27, 2016 Accepting new patients
Providence Medical Foundation Past Accepting new patients
Usc Arcadia Hospital Past Accepting new patients
Mad River Community Anesthesia Medical Group Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

2321 Harrison Ave
Eureka, CA 95501
Phone (707) 445-3660

2321 Harrison Ave
Ste S
Eureka, CA 95501
Phone (707) 443-2248

2379 23rd St
Eureka, CA 95501
Phone (707) 443-9371

3304 Renner Dr
Fortuna, CA 95540
Phone (707) 725-4477

3300 Renner Dr
Fortuna, CA 95540
Phone (707) 725-3361

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

Interoperability endpoints

  • Direct secure messaging: trydz1658232@oc.providencedirect.org

Organizations & group practices 8

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.

Hospital & facility affiliations 5

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1184781536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2321 HARRISON AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013216",
            "telephone_number": "707-445-3660",
            "fax_number": "707-476-8431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2321 HARRISON AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013216",
            "telephone_number": "707-445-3660",
            "fax_number": "707-476-8431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDZ",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G71695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G716950",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "trydz1658232@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2321 Harrison Ave",
            "city": "Eureka",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955013216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.