Individual provider Active NPI

Matthew Michael Thompson, D.O.

  • Anesthesiology Physician
  • San Diego, CA
National Provider Identifier
1336433507
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
DO201761 Issued in OR
Practice address
34800 Bob Wilson Drive
Naval Medical Ctr
San Diego, CA 92134-5000
Phone
(619) 545-4359
NPI assigned
Jun 6, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 943 NE
Anesthesiology Physician 207L00000X DO201761 OR Primary
Anesthesiology Physician 207L00000X 20A17688 CA

Addresses

Primary practice location

34800 Bob Wilson Drive
Naval Medical Ctr
San Diego, CA 92134-5000

Mailing address

PO Box 3330
Salt Lake City, UT 84110-3330
Phone (888) 333-1095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20210308002837 OR Practitioner - Anesthesiology 0143658054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bend Anesthesiology Group, PCGroup PAC ID 4880683788, 64 clinicians

Practice addresses (Care Compare)

2500 NE Neff Rd
Bend, OR 97701-6015
Phone (541) 382-4321

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A17688CAMDAnesthesiology Physician
DO201761ORMDAnesthesiology Physician
943NEMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bend Anesthesiology Group, PC Anesthesiology CurrentSince May 1, 2021 Accepting new patients

Locations

2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333

1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131

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.

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": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1336433507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3330",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841103330",
            "telephone_number": "888-333-1095",
            "fax_number": "770-701-6674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DRIVE",
            "address_2": "NAVAL MEDICAL CTR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921345000",
            "telephone_number": "619-545-4359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "MATTHEW",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-06",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NE",
            "license": "943",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "DO201761",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "20A17688",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.