Individual provider Active NPI

Thomas P Drakes, M.D.

  • Internal Medicine Physician
  • Valley SPGS, CA
National Provider Identifier
1386615995
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G31160 Issued in CA
Practice address
51 Wellness Way
Valley SPGS, CA 95252-9736
Phone
(209) 772-7070
NPI assigned
Jan 31, 2006
Last updated
Jul 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
M-11010OtherIDSTATE LICENSE
1386615995OtherIDBLUE CROSS OF IDAHO
G31160OtherCALICENSE

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210325000539 CA Practitioner - Internal Medicine 9436049897

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G31160CAMDInternal Medicine Physician
M-11010IDMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.