Individual provider Active NPI

Rexford Lee Thomas Jr., M.D

  • Surgery Physician
  • West Seneca, NY
National Provider Identifier
1629063235
Registry record updated Jul 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
191725 Issued in NY
Practice address
1026 Union Rd
West Seneca, NY 14224-3445
Phone
(716) 712-0851
Fax
(716) 712-0853
NPI assigned
Sep 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 191725 NY Primary

Addresses

Primary practice location

1026 Union Rd
West Seneca, NY 14224-3445

Mailing address

1026 Union Rd
West Seneca, NY 14224-3445
Phone (716) 712-0851

Other identifiers 5

IdentifierTypeStateIssuer
01977417MedicaidNY
1710862OtherNYIHA
000525722005OtherNYBC/BS
00026031604OtherNYUNIVERA
457959OtherNYWELLCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20050209000669 NY Practitioner - Family PracticePractitioner - General Surgery 5799736591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York at Buffalo School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southgate Medical Group LLPGroup PAC ID 7911810189, 31 clinicians

Practice addresses (Care Compare)

1026 Union Rd
West Seneca, NY 14224-3445
Phone (716) 712-0851

112 Olean St
East Aurora, NY 14052-2540
Phone (716) 712-0851

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy108
Hernia repair - groin (open)1-10
Melanoma (skin cancer) excision17
Removal of tissue1-10
Removal of skin lesions23
Removal or shaving of skin growth1-10
Skin biopsy15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
191725NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southgate Medical Group,LLP CurrentSince Oct 1, 2012 Accepting new patients
Genesee Valley Group Health Association Past Accepting new patients
Frontier Surgical Associates, LLP Surgery Past Accepting new patients

Locations

112 Olean St
Ste 220
East Aurora, NY 14052
Phone (716) 805-1072

1026 Union Rd
West Seneca, NY 14224
Phone (716) 712-0851

Interoperability endpoints

  • Direct secure messaging: drthomas@smg.medentdirect.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406073600000",
    "number": "1629063235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 UNION RD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142243445",
            "telephone_number": "716-712-0851",
            "fax_number": "716-712-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 UNION RD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142243445",
            "telephone_number": "716-712-0851",
            "fax_number": "716-712-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "REXFORD",
        "middle_name": "LEE",
        "name_suffix": "Jr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2014-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "191725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01977417",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "1710862",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000525722005",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00026031604",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "457959",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Seneca, NY

Sources for this page

Verify at the official NPI Registry.