Active NPI
Thomas W Rohde, M.D.
- Family Medicine Physician
- Decatur, IL
National Provider Identifier
1407833163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036-081038
- Practice address
- 3798 E Fulton Ave
Decatur, IL 62521-5053 - Phone
- (217) 864-2700
- Fax
- (217) 422-3930
- NPI assigned
- Dec 23, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036-081038 | IL | Primary |
| Adult Medicine Physician | 207QA0505X | A46499 | CA |
Addresses
Primary practice location
3798 E Fulton Ave
Decatur, IL 62521-5053
Mailing address
3798 E Fulton Ave
Decatur, IL 62521-5053
Phone (217) 864-2700
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036081038 | Medicaid | IL | |
| K39345 | Other | IL | MEDICARE PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2016 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-081038 | IL | MD | Family Medicine Physician |
| A46499 | CA | MD | Adult Medicine Physician |
Interoperability endpoints
- thomasrohde@renew.medentdirect.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319500800000",
"number": "1407833163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3798 E FULTON AVE",
"city": "DECATUR",
"state": "IL",
"postal_code": "625215053",
"telephone_number": "217-864-2700",
"fax_number": "217-422-3930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3798 E FULTON AVE",
"city": "DECATUR",
"state": "IL",
"postal_code": "625215053",
"telephone_number": "217-864-2700",
"fax_number": "217-422-3930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROHDE",
"first_name": "THOMAS",
"middle_name": "W",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-23",
"last_updated": "2011-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036-081038",
"primary": true
},
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "CA",
"license": "A46499",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036081038",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PROVIDER NUMBER",
"identifier": "K39345",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Decatur, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.