Individual provider Active NPI

Thomas Wilder Stinson III, M.D.

  • Addiction Medicine (Anesthesiology) Physician
  • Woburn, MA
National Provider Identifier
1275504862
Registry record updated Mar 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Anesthesiology) PhysicianTaxonomy code 207LA0401X
License
39897 Issued in MA
Practice address
400 W Cummings Park
Ste 1825
Woburn, MA 01801-6519
Phone
(781) 820-9732
Fax
(781) 989-9396
NPI assigned
Jan 31, 2006
Last updated
Mar 2, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Anesthesiology) Physician 207LA0401X 39897 MA Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X 39897 MA

Addresses

Primary practice location

400 W Cummings Park
Ste 1825
Woburn, MA 01801-6519

Mailing address

400 W Cummings Park
Suite 1825
Woburn, MA 01801-6519
Phone (781) 820-9732

Other identifiers 7

IdentifierTypeStateIssuer
6184456MedicaidMA
J03510OtherMABLUE CROSS & BLUE SHIELD
039897OtherMATUFTS ASSOC. HEALTH PLANS
050031023OtherRAILROAD MEDICARE-GBA PAL
AA17224OtherMAHARVARD PILGRIM HEALTH
30201011MedicaidNH
992959OtherMANETWORK HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330646400000",
    "number": "1275504862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W CUMMINGS PARK",
            "address_2": "SUITE 1825",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016519",
            "telephone_number": "781-820-9732",
            "fax_number": "781-989-9396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W CUMMINGS PARK",
            "address_2": "STE 1825",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016519",
            "telephone_number": "781-820-9732",
            "fax_number": "781-989-9396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINSON",
        "first_name": "THOMAS",
        "middle_name": "WILDER",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2012-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LA0401X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Addiction Medicine",
            "state": "MA",
            "license": "39897",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MA",
            "license": "39897",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6184456",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "J03510",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS ASSOC. HEALTH PLANS",
            "identifier": "039897",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE-GBA PAL",
            "identifier": "050031023",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTH",
            "identifier": "AA17224",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30201011",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "992959",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.