Thomas Edward Booth, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G69034 Issued in CA

Practice address

2001 Winward Way Ste 101
San Mateo, CA 94404-2499

Phone

(650) 288-0596

NPI assigned

Jun 3, 2006

Last updated

Oct 5, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Bay Area Medrehab

  • Internal Medicine Physician
  • Burlingame, CA
  • NPI 1902263767
  Authorized official Same address or phone
• Inpatient Consultants of California, Inc

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1992189286
  NPD (past)
• Mills Peninsula Medical Group

  • General Practice Physician
  • San Mateo, CA
  • NPI 1588879134
  NPD (past)
• Mills-Peninsula Health Services

  dba Mills Hospital

  • Rehabilitation Hospital
  • San Mateo, CA
  • NPI 1770527251
  NPD (past)

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1245278027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 CAPSTAN CT",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940651024",
            "telephone_number": "650-868-2846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 WINWARD WAY STE 101",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944042499",
            "telephone_number": "650-288-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "THOMAS",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G69034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ernesto Joaquin Bonilla
• Lisbeth Susana Bonilla
• Raquel Bonilla
• Joi Booker Enemuoh
• Yolanda Booker
• Jacob Boots
• Eve Marie Bordoli, MS, CCC-SLP
• Heather Rae Borges, SUDRC 21446
• Taylor Darling Borges
• Vitel Born, LMFT

• Internal Medicine Physician in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.