Individual provider Active NPI

Thomas Wayne McGill, MD

  • Pediatric Surgery Physician
  • Lubbock, TX
National Provider Identifier
1659335818
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
M0169 Issued in TX
Practice address
3601 4TH St
Stop 8312
Lubbock, TX 79430-8312
Phone
(806) 743-2373
Fax
(806) 743-4354
NPI assigned
Apr 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X M0169 TX Primary

Addresses

Primary practice location

3601 4TH St
Stop 8312
Lubbock, TX 79430-8312

Mailing address

PO Box 5865
Lubbock, TX 79408-5865
Phone (806) 743-2898

Other identifiers 2

IdentifierTypeStateIssuer
172075701MedicaidTX
172075705MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address thomas.mcgill@direct.myteamcare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050302000997 TX Practitioner - Pediatric MedicinePractitioner - General Surgery 6507825825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: General Surgery
Education
Eastern Virginia Medical School, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3601 4TH St
Lubbock, TX 79430-9436
Phone (806) 743-2475

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M0169TXMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Dec 16, 2010 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Dec 16, 2010 Accepting new patients
Covenant Medical Group PastSince Aug 1, 2008 Accepting new patients
Lubbock County Hospital District Past Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients
Covenant Medical Group Past Accepting new patients

Locations

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

3601 4th St
Stop 8312
Lubbock, TX 79430
Phone (806) 743-2332

Interoperability endpoints

  • Direct secure messaging: thomas.mcgill@direct.myteamcare.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1659335818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5865",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794085865",
            "telephone_number": "806-743-2898",
            "fax_number": "806-743-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 4TH ST",
            "address_2": "STOP 8312",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794308312",
            "telephone_number": "806-743-2373",
            "fax_number": "806-743-4354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGILL",
        "first_name": "THOMAS",
        "middle_name": "WAYNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "TX",
            "license": "M0169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172075701",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172075705",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thomas.mcgill@direct.myteamcare.com",
            "affiliation": "N",
            "address_1": "3601 4th St",
            "address_2": "stop 8312",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794308312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.