Individual provider Active NPI

Thomas Edward Kibelstis, M.D.

  • Family Medicine Physician
  • Tucson, AZ
National Provider Identifier
1215062831
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
55189 Issued in AZ
Practice address
10350 E Drexel Rd Unit 110
Tucson, AZ 85747-9409
Phone
(520) 324-1727
Fax
(520) 324-1700
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD.13795R LA
Family Medicine Physician 207Q00000X MD479096 PA
Family Medicine Physician 207Q00000X 55189 AZ Primary

Addresses

Primary practice location

10350 E Drexel Rd Unit 110
Tucson, AZ 85747-9409

Mailing address

PO Box 31235
Tucson, AZ 85751-1235
Phone (520) 324-4100

Other practice location 1

1991 Sproul Rd Ste 140
Broomall, PA 19008-3518
Phone (610) 325-0309

Other practice location 2

9356 E Rita Rd Ste 180
Tucson, AZ 85747-6318
Phone (520) 324-4499

Other practice location 3

70 N Harrison Rd
Tucson, AZ 85748-3260
Phone (520) 324-4403

Other identifiers 1

IdentifierTypeStateIssuer
526856MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20221122001544 PA Practitioner - Family Practice 4789872441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Temple University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

1991 Sproul Rd
Broomall, PA 19008-3512
Phone (610) 325-1390

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55189AZMDFamily Medicine Physician
MD.13795RLAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Family Medicine CurrentSince Oct 15, 2022 Accepting new patients

Locations

1991 Sproul Rd
Ste 140
Broomall, PA 19008
Phone (610) 325-0309

1991 Sproul Rd
Broomall, PA 19008
Phone (484) 476-3700

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530

Organizations & group practices 1

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 6

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1215062831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31235",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857511235",
            "telephone_number": "520-324-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10350 E DREXEL RD UNIT 110",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857479409",
            "telephone_number": "520-324-1727",
            "fax_number": "520-324-1700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1991 Sproul Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Broomall",
            "state": "PA",
            "postal_code": "190083518",
            "country_code": "US",
            "telephone_number": "610-325-0309",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9356 E Rita Rd Ste 180",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857476318",
            "country_code": "US",
            "telephone_number": "520-324-4499",
            "fax_number": "520-324-4492",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "70 N Harrison Rd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857483260",
            "country_code": "US",
            "telephone_number": "520-324-4403",
            "fax_number": "520-324-1409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIBELSTIS",
        "first_name": "THOMAS",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD.13795R",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD479096",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "55189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "526856",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.