Individual provider Active NPI

Thomas J Welle, D.O.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Santa Cruz, CA
National Provider Identifier
1285711242
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
20A7124 Issued in CA
Practice address
2907 Chanticleer Ave.
Santa Cruz, CA 95065-1815
Phone
(831) 477-2325
Fax
(831) 477-2330
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 20A7124 CA Primary
Orthopaedic Surgery Physician 207X00000X 20A7124 CA

Addresses

Primary practice location

2907 Chanticleer Ave.
Santa Cruz, CA 95065-1815

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (831) 476-0660

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050620000176 CA Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 8325935463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
College of Osteo Med of the Pacific at Pomona, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

2900 Chanticleer Ave
Santa Cruz, CA 95065-1816

2907 Chanticleer Ave
Santa Cruz, CA 95065-1815
Phone (831) 477-2375

2911 Chanticleer Ave
Santa Cruz, CA 95065-1815
Phone (831) 477-2350

2915 Chanticleer Ave
Santa Cruz, CA 95065-1815
Phone (831) 477-2375

550 S Green Valley Rd
Watsonville, CA 95076-3053
Phone (831) 458-5865

795 El Camino Real
Palo Alto, CA 94301-2302
Phone (415) 600-1020

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)23
Upper limb (arm) arthroscopy (minimally invasive joint repair)65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A7124CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Mar 22, 2009 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Mar 22, 2009 Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Santa Cruz Medical Clinic, Inc Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174

795 El Camino Real
#1112
Palo Alto, CA 94301

2025 Soquel Ave
Santa Cruz, CA 95062
Phone (408) 423-4111

2907 Chanticleer Ave
Santa Cruz, CA 95065
Phone (831) 477-2325

1662 Dominican Way
Santa Cruz, CA 95065
Phone (408) 475-1100

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: twelledo59940@hisp.ehr.sutterhealth.org

Organizations & group practices 5

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 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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1285711242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "831-476-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2907 CHANTICLEER AVE.",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651815",
            "telephone_number": "831-477-2325",
            "fax_number": "831-477-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLE",
        "first_name": "THOMAS",
        "middle_name": "J",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "20A7124",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "20A7124",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.