Individual provider Active NPI

Kelly Thomas

  • Physical Medicine & Rehabilitation Physician
  • San Diego, CA
National Provider Identifier
1356074017
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
18248 Issued in CA
Practice address
2204 Garnet Ave Ste 101
San Diego, CA 92109-3771
Phone
(858) 224-7970
NPI assigned
Jul 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 18248 CA Primary

Addresses

Primary practice location

2204 Garnet Ave Ste 101
San Diego, CA 92109-3771

Mailing address

6699 Alvarado Rd Ste 2100
San Diego, CA 92120-5238
Phone (619) 229-3929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221121000905 CA Practitioner - Physical Therapist in Private Practice 2264800416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Wisconsin School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SD Sports Medicine and Family Health CenterGroup PAC ID 7113812496, 38 clinicians

Practice addresses (Care Compare)

6699 Alvarado Rd
Suite 2100
San Diego, CA 92120-5238
Phone (619) 229-3909

Merit-based Incentive Payment System (MIPS)

Final score
90.4 of 100Reported as group
Quality
93.75
Promoting interoperability
100
Improvement activities
40
Cost
74.23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
SD Sports Medicine and Family Health Center CurrentSince Jul 6, 2022 Accepting new patients
Regents of the University of California Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

2204 Garnet Ave
Ste 101
San Diego, CA 92109
Phone (858) 224-7970

4010 Morena Blvd
Ste 210
San Diego, CA 92117
Phone (858) 224-7970

6699 Alvarado Rd
Ste 2100
San Diego, CA 92120
Phone (619) 229-3909

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1356074017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6699 ALVARADO RD STE 2100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205238",
            "telephone_number": "619-229-3929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 GARNET AVE STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921093771",
            "telephone_number": "858-224-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-08",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "18248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.