Individual provider Active NPI

Melanie Marie Thomas, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Mary Esther, FL
National Provider Identifier
1205070083
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
ME107738 Issued in FL
Practice address
729 Forest Shores Dr
Mary Esther, FL 32569-2704
Phone
(415) 851-5223
NPI assigned
Apr 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME107738 FL
Endocrinology, Diabetes & Metabolism Physician 207RE0101X ME107738 FL Primary

Addresses

Primary practice location

729 Forest Shores Dr
Mary Esther, FL 32569-2704

Mailing address

729 Forest Shores Dr
Mary Esther, FL 32569-2704
Phone (415) 851-5223

Other practice location 1

1025 Beal Pkwy NW
Fort Walton Beach, FL 32547
Phone (850) 278-3490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20141001002409 FL Practitioner - Endocrinology 7810117561 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME107738FLMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. Current Accepting new patients

Locations

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1205070083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 FOREST SHORES DR",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325692704",
            "telephone_number": "415-851-5223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 FOREST SHORES DR",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325692704",
            "telephone_number": "415-851-5223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 Beal Pkwy NW",
            "address_purpose": "LOCATION",
            "city": "Fort Walton Beach",
            "state": "FL",
            "postal_code": "32547",
            "country_code": "US",
            "telephone_number": "850-278-3490",
            "fax_number": "850-278-3491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MELANIE",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-24",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME107738",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME107738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mary Esther, FL

Sources for this page

Verify at the official NPI Registry.