Individual provider Active NPI

Thomas Michael Bockman, MD

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1578772471
Registry record updated Feb 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD433424 Issued in PA
Practice address
2505 Wedglea Dr
Apt #234
Dallas, TX 75211-2037
Phone
(214) 566-6537
NPI assigned
May 21, 2007
Last updated
Feb 9, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X MD433424 PA Primary
Internal Medicine Physician 207R00000X N0653 TX

Addresses

Primary practice location

2505 Wedglea Dr
Apt #234
Dallas, TX 75211-2037

Mailing address

2505 Wedglea Dr
Apt #234
Dallas, TX 75211-2037
Phone (214) 566-6537

Other identifiers 1

IdentifierTypeStateIssuer
BP1-0017690OtherINSTITUTIONAL PERMIT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110414000823 TX Practitioner - Internal Medicine 4183808199 Reassigns benefits to 1 organization
I20180810001026 NM Practitioner - Internal Medicine 4183808199 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD433424PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Internal Medicine Current Accepting new patients
Presbyterian Healthcare Services Internal Medicine CurrentSince May 17, 2024 Accepting new patients
Christus Trinity Clinic Texas Internal Medicine CurrentSince Jul 1, 2017 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jul 1, 2017 Accepting new patients

Locations

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

8300 Constitution Ave NE
Albuquerque, NM 87110
Phone (505) 291-2000

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

1600 Broadway Ave
Gladewater, TX 75647
Phone (903) 315-5630

700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000

811 S Washington Ave
Marshall, TX 75670
Phone (903) 315-1488

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: tbockman122425@direct.phs.org

Organizations & group practices 4

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265673600000",
    "number": "1578772471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 WEDGLEA DR",
            "address_2": "APT #234",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752112037",
            "telephone_number": "214-566-6537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 WEDGLEA DR",
            "address_2": "APT #234",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752112037",
            "telephone_number": "214-566-6537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCKMAN",
        "first_name": "THOMAS",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2010-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD433424",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N0653",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSTITUTIONAL PERMIT",
            "identifier": "BP1-0017690",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.