Individual provider Active NPI

Thomas Deetz, M.D.

  • Infectious Disease Physician
  • Santa Cruz, CA
National Provider Identifier
1336129469
Registry record updated May 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
G43367 Issued in CA
Practice address
2025 Soquel Ave
Santa Cruz, CA 95062-1323
Phone
(831) 458-5820
NPI assigned
Jan 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X G43367 CA Primary

Addresses

Primary practice location

2025 Soquel Ave
Santa Cruz, CA 95062-1323

Mailing address

2025 Soquel Ave
Santa Cruz, CA 95062-1323
Phone (831) 458-5597

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Stanford University School of Medicine, 1970
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2025 Soquel Ave
Santa Cruez, CA 95062-1323

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G43367CAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Cruz Medical Clinic, Inc Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305676800000",
    "number": "1336129469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 SOQUEL AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950621323",
            "telephone_number": "831-458-5597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 SOQUEL AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950621323",
            "telephone_number": "831-458-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEETZ",
        "first_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2011-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "G43367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.