Active NPI
Michael Scott Thomas, PH.D.
- Clinical Psychologist
- Modesto, CA
National Provider Identifier
1609977875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 18192
- Practice address
- 3425 Coffee Rd
Suite 2a
Modesto, CA 95355-1582 - Phone
- (209) 524-9402
- NPI assigned
- Sep 26, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 18192 | CA | Primary |
Addresses
Primary practice location
3425 Coffee Rd
Suite 2a
Modesto, CA 95355-1582
Mailing address
600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 521-6097
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3425 Coffee Rd
Suite A2
Modesto, CA 95355-1582
Phone (209) 524-9401
600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 524-1211
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 18192 | CA | MD | Clinical Psychologist |
Organizations & group practices 1
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.
-
dba Sutter Gould Medical Foundation
- Multi-Specialty Clinic/Center
- Modesto, CA
- NPI 1669846986
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432857600000",
"number": "1609977875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 COFFEE RD",
"city": "MODESTO",
"state": "CA",
"postal_code": "953554201",
"telephone_number": "209-521-6097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3425 COFFEE RD",
"address_2": "SUITE 2A",
"city": "MODESTO",
"state": "CA",
"postal_code": "953551582",
"telephone_number": "209-524-9402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "MICHAEL",
"middle_name": "SCOTT",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2015-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 18192",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.