Individual provider Active NPI

Thomas Wheeler Stark, MD

  • Otolaryngology Physician
  • Phoenix, AZ
National Provider Identifier
1205924008
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
75440 Issued in AZ
Practice address
2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone
(602) 344-5011
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X F2040 TX
Otolaryngology Physician 207Y00000X 75440 AZ Primary

Addresses

Primary practice location

2601 E Roosevelt St
Phoenix, AZ 85008-4973

Mailing address

2929 E Thomas Rd
Phoenix, AZ 85016-8034
Phone (602) 470-5000

Other practice location 1

18059 Highway 105 W
Suite 115
Montgomery, TX 77356-5000
Phone (281) 576-1030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MA, AZ, NM4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20110105000630 TX Practitioner - Otolaryngology 7517156631
I20240423000257 MA Practitioner - Otolaryngology 7517156631 Reassigns benefits to 1 organization
I20250205003442 AZ Practitioner - Otolaryngology 7517156631 Reassigns benefits to 1 organization
I20250207002774 NM Practitioner - Otolaryngology 7517156631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Texas Medical School at San Antonio, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent HospitalGroup PAC ID 6608775135, 335 clinicians

Practice addresses (Care Compare)

1631 Hospital Dr
Suite 112
Santa Fe, NM 87505-4728
Phone (505) 913-4780

433 Saint Michaels Dr
Santa Fe, NM 87505-7601
Phone (505) 988-1232

445 Saint Michaels Dr
Santa Fe, NM 87505-7601
Phone (505) 913-8900

455 Saint Michaels Dr
Santa Fe, NM 87505-7601

465 Saint Michaels Dr
Suite 230
Santa Fe, NM 87505-8602
Phone (505) 913-4710

Hospital & facility affiliations

  • Christus St Vincent Regional Medical Center Hospital, Santa Fe, NM, CCN 320002

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F2040TXMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic, Inc. Otolaryngology CurrentSince May 1, 2024 Accepting new patients
District Medical Group, Inc CurrentSince Dec 20, 2024 Accepting new patients
St Vincent Hospital Otolaryngology CurrentSince Jan 16, 2025 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Berkshire Faculty Services Inc CurrentSince Mar 4, 2024 Accepting new patients
Deaconess Clinic Inc. Current Accepting new patients
Fairview Hospital CurrentSince Mar 4, 2024 Accepting new patients
Deaconess Clinic Inc Family Medicine CurrentSince May 1, 2024 Accepting new patients
District Medical Group, Inc CurrentSince Dec 20, 2024 Accepting new patients
St. Vincent Hospital Family Medicine CurrentSince Jan 16, 2025 Accepting new patients
St Vincent Hospital Current Accepting new patients

Locations

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

2601 E Roosevelt St
Ste 0D10
Phoenix, AZ 85008

2525 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 344-1015

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

350 W Columbia St
Ste 310
Evansville, IN 47710
Phone (812) 425-2646

4015 Gateway Blvd
Newburgh, IN 47630
Phone (812) 858-6244

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

780 S Main St
Ste 2
Gt Barrington, MA 01230
Phone (413) 447-2498

725 North St
Pittsfield, MA 01201
Phone (413) 447-2839

510 North St
Ste 10
Pittsfield, MA 01201
Phone (413) 448-8291

455 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 913-3361

1631 Hospital Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 424-0200

465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901

Interoperability endpoints

  • Direct secure messaging: drstark@twsmp-tx.direct.office.nextgen.com
  • Direct secure messaging: tstark505353@christushealth.direct-ci.net
  • Direct secure messaging: tstark276825@direct.valleywisehealth.org

Organizations & group practices 12

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 1

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1205924008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168034",
            "telephone_number": "602-470-5000",
            "fax_number": "602-470-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084973",
            "telephone_number": "602-344-5011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18059 Highway 105 W",
            "address_2": "Suite 115",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "TX",
            "postal_code": "773565000",
            "country_code": "US",
            "telephone_number": "281-576-1030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STARK",
        "first_name": "THOMAS",
        "middle_name": "WHEELER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "F2040",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AZ",
            "license": "75440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.