Individual provider Active NPI

Thomas P Di Julio, M.D.

  • Specialist
  • Long Beach, CA
National Provider Identifier
1396712188
Registry record updated Mar 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G30897 Issued in CA
Practice address
1703 Termino Ave
#208
Long Beach, CA 90804-2124
Phone
(562) 498-1182
Fax
(562) 985-0522
NPI assigned
Mar 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G30897 CA Primary

Addresses

Primary practice location

1703 Termino Ave
#208
Long Beach, CA 90804-2124

Mailing address

PO Box 15160
Long Beach, CA 90815-0160
Phone (562) 425-3229

Other identifiers 4

IdentifierTypeStateIssuer
343789000OtherUS DEPT OF LABOR (ASC)
00G30870MedicaidCA
130001756OtherCARAILROAD MEDICARE
00G308970OtherCABLUE SHIELD

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
I20100921000344 CA Practitioner - Neurology 1355466889

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas P. Di Julio, M.D., Inc Specialist CurrentSince Jul 13, 2010 Accepting new patients
Long Beach Memorial Medical PastSince Jul 13, 2010 Accepting new patients

Locations

1703 Termino Ave
Ste 208
Long Beach, CA 90804
Phone (562) 425-3229

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331164800000",
    "number": "1396712188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15160",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908150160",
            "telephone_number": "562-425-3229",
            "fax_number": "562-421-8114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 TERMINO AVE",
            "address_2": "#208",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908042124",
            "telephone_number": "562-498-1182",
            "fax_number": "562-985-0522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DI JULIO",
        "first_name": "THOMAS",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2012-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G30897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR (ASC)",
            "identifier": "343789000",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G30870",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "130001756",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G308970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.