NPIMap

Individual provider Active NPI

Thomas William Church, M.D.

  • Diagnostic Radiology Physician
  • Lima, OH
National Provider Identifier
1629038153
Registry record updated Feb 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
35.049094 Issued in OH
Practice address
730 W Market St
Lima, OH 45801-4602
Phone
(419) 227-3361
NPI assigned
Mar 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 35.049094 OH Primary

Addresses

Primary practice location

730 W Market St
Lima, OH 45801-4602

Mailing address

5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone (800) 288-8325

Other identifiers 4

IdentifierTypeStateIssuer
0758836MedicaidOH
000000177812OtherOHANTHEM BCBS
300044081OtherOHRAILROAD MEDICARE
300117621OtherOHRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040308000419 OH Practitioner - Diagnostic Radiology 0648167460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Wisconsin School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lima Radiological AssociatesGroup PAC ID 9931003977, 50 clinicians

Practice addresses (Care Compare)

730 W Market St
Lima, OH 45801-4602
Phone (419) 226-9023

Hospital & facility affiliations

  • Mercy Health St Ritas Medical Center Hospital, Lima, OH, CCN 360066
  • Lima Memorial Health System Hospital, Lima, OH, CCN 360009
  • Mercer County Joint Township Community Hospital Hospital, Coldwater, OH, CCN 360058
  • Grand Lake Health System Hospital, Saint Marys, OH, CCN 360032
  • Mercy Health - Tiffin Hospital Hospital, Tiffin, OH, CCN 360089

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.049094OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Radiological Associates Diagnostic Radiology CurrentSince Oct 1, 1986 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

L3837
Columbus, OH 43260

730 W Market St
Lima, OH 45801
Phone (419) 226-4310

5700 Southwyck Blvd
Toledo, OH 43614

Interoperability endpoints

  • Direct secure messaging: tchurch56045@direct.bsmhealth.org

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1629038153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 W MARKET ST",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458014602",
            "telephone_number": "419-227-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "THOMAS",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35.049094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0758836",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000177812",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300044081",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300117621",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.