Individual provider Active NPI

Thomas Huntington I, MD

  • Emergency Medicine Physician
  • Angola, IN
National Provider Identifier
1215963293
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01060546A Issued in IN
Practice address
416 E Maumee St
Angola, IN 46703-2001
Phone
(260) 667-5503
NPI assigned
Jun 23, 2006
Last updated
May 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01060546A IN Primary

Addresses

Primary practice location

416 E Maumee St
Angola, IN 46703-2001

Mailing address

608 Union Chapel Rd
Fort Wayne, IN 46845-9357
Phone (260) 498-2022

Other identifiers 4

IdentifierTypeStateIssuer
01060546AOtherININDIANA LICENSE
4301053735OtherMICONTROLLED SUBSTANCE LIC
01060546BOtherINCSR
4301053735OtherMIPHYSICIAN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20050610000725 IN Practitioner - Emergency MedicinePractitioner - Internal Medicine 9739073735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Emergency Physicians PCGroup PAC ID 2769384213, 79 clinicians

Practice addresses (Care Compare)

416 E Maumee St
Angola, IN 46703-2015
Phone (260) 665-2141

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.38 of 100Reported as group
Quality
87.23
Promoting interoperability
100
Improvement activities
40
Cost
83.74

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01060546AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Emergency Physicians PC Emergency Medicine CurrentSince Nov 25, 2015 Accepting new patients
Indiana Physician Management-Randolph, LLC Emergency Medicine Past Accepting new patients
Emgi-Ball, LLC Emergency Medicine Past Accepting new patients
Icem-Ball, LLC Emergency Medicine Past Accepting new patients
Emergency Physicians of Delaware County, P.C. Emergency Medicine Past Accepting new patients
Niles Professional Services, Inc Past Accepting new patients
Emergency Medicine of Indiana Emergency Medicine Past Accepting new patients

Locations

416 E Maumee St
Angola, IN 46703
Phone (260) 665-2141

2200 Randallia Dr
Fort Wayne, IN 46805
Phone (260) 373-4000

3640 New Vision Dr
Ste A
Fort Wayne, IN 46845

608 Union Chapel Rd
Fort Wayne, IN 46845
Phone (260) 387-0450

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1215963293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 UNION CHAPEL RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459357",
            "telephone_number": "260-498-2022",
            "fax_number": "260-498-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 E MAUMEE ST",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032001",
            "telephone_number": "260-667-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNTINGTON",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01060546A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA LICENSE",
            "identifier": "01060546A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE LIC",
            "identifier": "4301053735",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSR",
            "identifier": "01060546B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE",
            "identifier": "4301053735",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Angola, IN

Sources for this page

Verify at the official NPI Registry.