Active NPI
Thomas J Duntemann, MD
- Gastroenterology Physician
- Suffolk, VA
National Provider Identifier
1336123074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 0101053921
- Practice address
- 5818 Harbour View Blvd
Suite 240
Suffolk, VA 23435 - Phone
- (757) 483-6100
- Fax
- (757) 483-2203
- NPI assigned
- Dec 6, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 0101053921 | VA | Primary |
Addresses
Primary practice location
5818 Harbour View Blvd
Suite 240
Suffolk, VA 23435
Mailing address
5818 Harbour View Blvd
Suite 240
Suffolk, VA 23435
Phone (757) 483-6100
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 541870984028 | Other | CIGNA | |
| C13214 | Other | MEDICARE RR GROUP | |
| 0058201504 | Other | MEDICAID FIRST HEALTH | |
| 110176759 | Other | TRAVELERS RR MEDICARE | |
| 209383 | Other | ANTHEM OBICI | |
| 264925 | Other | MAMSI OPT CHOICE | |
| 100000220 | Other | MEDICARE TRAILBLAZERS | |
| 541870984 | Other | VA HEALTH NETWORK | |
| 541870984006 | Other | CHAMPUS | |
| 69328 | Other | SENTARA OPTIMA | |
| 005820154 | Medicaid | VA | |
| 790528L | Medicaid | NC | |
| C05825 | Other | MEDICARE GROUP | |
| 325221 | Other | ANTHEM HBV |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266969600000",
"number": "1336123074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5818 HARBOUR VIEW BLVD",
"address_2": "SUITE 240",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "23435",
"telephone_number": "757-483-6100",
"fax_number": "757-483-2203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5818 HARBOUR VIEW BLVD",
"address_2": "SUITE 240",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "23435",
"telephone_number": "757-483-6100",
"fax_number": "757-483-2203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNTEMANN",
"first_name": "THOMAS",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-06",
"last_updated": "2010-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "VA",
"license": "0101053921",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "541870984028",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR GROUP",
"identifier": "C13214",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID FIRST HEALTH",
"identifier": "0058201504",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRAVELERS RR MEDICARE",
"identifier": "110176759",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM OBICI",
"identifier": "209383",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI OPT CHOICE",
"identifier": "264925",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE TRAILBLAZERS",
"identifier": "100000220",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VA HEALTH NETWORK",
"identifier": "541870984",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "541870984006",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENTARA OPTIMA",
"identifier": "69328",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "005820154",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "790528L",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "C05825",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM HBV",
"identifier": "325221",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Suffolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.