Active NPI
Thomas P Drakes, M.D.
- Internal Medicine Physician
- Valley SPGS, CA
National Provider Identifier
1386615995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- G31160
- Practice address
- 51 Wellness Way
Valley SPGS, CA 95252-9736 - Phone
- (209) 772-7070
- NPI assigned
- Jan 31, 2006
- Last updated
- Jul 1, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | G31160 | CA | Primary |
| Hematology & Oncology Physician | 207RH0003X | M-11010 | ID |
Addresses
Primary practice location
51 Wellness Way
Valley SPGS, CA 95252-9736
Mailing address
51 Wellness Way
Valley SPGS, CA 95252-9736
Phone (209) 772-7070
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| M-11010 | Other | ID | STATE LICENSE |
| 1386615995 | Other | ID | BLUE CROSS OF IDAHO |
| G31160 | Other | CA | LICENSE |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210325000539 | CA | Practitioner - Internal Medicine | 9436049897 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G31160 | CA | MD | Internal Medicine Physician |
| M-11010 | ID | MD | Hematology & Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Joseph Hospital, LLC | Past | Accepting new patients | |
| Sonora Community Hospital | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Retail Pharmacy
- Sonora, CA
- NPI 1740582568
-
- Psychiatric Hospital Unit
- Lewiston, ID
- NPI 1205975851
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625097600000",
"number": "1386615995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 WELLNESS WAY",
"city": "VALLEY SPGS",
"state": "CA",
"postal_code": "952529736",
"telephone_number": "209-772-7070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 WELLNESS WAY",
"city": "VALLEY SPGS",
"state": "CA",
"postal_code": "952529736",
"telephone_number": "209-772-7070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRAKES",
"first_name": "THOMAS",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-31",
"last_updated": "2021-07-01",
"certification_date": "2021-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "G31160",
"primary": true
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "ID",
"license": "M-11010",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "M-11010",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF IDAHO",
"identifier": "1386615995",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "G31160",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.