NPIMap

Individual provider Active NPI

Thomas Bumbalo, MD

  • Pulmonary Disease Physician
  • Myrtle Beach, SC
National Provider Identifier
1386759488
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
36512 Issued in SC
Practice address
906 Medical Cir
Myrtle Beach, SC 29572-4114
Phone
(843) 497-5929
Fax
(843) 839-1037
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 36512 SC
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 36512 SC
Pulmonary Disease Physician 207RP1001X 36512 SC Primary

Addresses

Primary practice location

906 Medical Cir
Myrtle Beach, SC 29572-4114

Mailing address

PO Box 3439
North Myrtle Beach, SC 29582-0439
Phone (843) 839-4447

Other practice location 1

809 82nd Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 692-1000

Other identifiers 1

IdentifierTypeStateIssuer
365125MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140825000066 SC Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 0042233397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine
Education
State University of New York at Buffalo School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Strand Physician Specialists PA 56 clinicians

Practice addresses (Care Compare)

906 Medical Cir
Myrtle Beach, SC 29572-4114
Phone (843) 497-5929

Hospital & facility affiliations

  • Grand Strand Regional Medical Center Hospital, Myrtle Beach, SC, CCN 420085
  • Tidelands Waccamaw Community Hospital Hospital, Murrells Inlet, SC, CCN 420098
  • McLeod Loris Hospital Hospital, Loris, SC, CCN 420105
  • Conway Medical Center Hospital, Conway, SC, CCN 420049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Strand Physician Specialists, PA Internal Medicine CurrentSince Mar 1, 2015 Accepting new patients
Strand Physician Specialists, PA Internal Medicine CurrentSince Mar 1, 2015 Accepting new patients
Strand Physician Specialists, PA Internal Medicine Current Accepting new patients
Strand Physician Specialists, PA Internal Medicine Past Accepting new patients
Wilmington Health PLLC Past Accepting new patients
Health Sciences Foundation Inc. Internal Medicine Past Accepting new patients

Locations

3361 Highway 9 E
Little River, SC 29566
Phone (843) 449-8079

906 Medical Cir
Myrtle Beach, SC 29572

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

4591 Socastee Blvd
Myrtle Beach, SC 29588

945 82nd Pkwy
Myrtle Beach, SC 29572

Interoperability endpoints

  • Direct secure messaging: thomas.bumbalo.1@842.direct.athenahealth.com

Organizations & group practices 7

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 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1386759488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3439",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295820439",
            "telephone_number": "843-839-4447",
            "fax_number": "843-399-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 MEDICAL CIR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724114",
            "telephone_number": "843-497-5929",
            "fax_number": "843-839-1037"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "809 82nd Pkwy",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295724607",
            "country_code": "US",
            "telephone_number": "843-692-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUMBALO",
        "first_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "36512",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "SC",
            "license": "36512",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "SC",
            "license": "36512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "365125",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.