Individual provider Active NPI

Zachary Simon Thomas, M.D.

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1326453119
Registry record updated Sep 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A145023 Issued in CA
Practice address
5454 El Cajon Blvd
San Diego, CA 92115-3621
Phone
(619) 515-2400
Fax
(619) 906-4564
NPI assigned
Jun 30, 2014
Last updated
Sep 28, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X A145023 CA Primary

Addresses

Primary practice location

5454 El Cajon Blvd
San Diego, CA 92115-3621

Mailing address

823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 906-4623

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
I20171011003370 CA Practitioner - Family Practice 1557636867 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A145023CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc CurrentSince Sep 28, 2017 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Sep 28, 2017 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients

Locations

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

5454 El Cajon Blvd
San Diego, CA 92115
Phone (619) 515-2381

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 3

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": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506556800000",
    "number": "1326453119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-906-4623",
            "fax_number": "619-906-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5454 EL CAJON BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921153621",
            "telephone_number": "619-515-2400",
            "fax_number": "619-906-4564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "ZACHARY",
        "middle_name": "SIMON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-30",
        "last_updated": "2017-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A145023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.