NPIMap

Individual provider Active NPI

Michael A Thursby, DO

  • Nephrology Physician
  • East Providence, RI
National Provider Identifier
1669455192
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
00502 Issued in RI
Practice address
318 Waterman Ave
East Providence, RI 02914
Phone
(401) 438-5950
Fax
(401) 435-6700
NPI assigned
Nov 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 213316 MA
Nephrology Physician 207RN0300X 00502 RI Primary

Addresses

Primary practice location

318 Waterman Ave
East Providence, RI 02914

Mailing address

318 Waterman Ave
East Providence, RI 02914-3525
Phone (401) 438-5950

Other identifiers 13

IdentifierTypeStateIssuer
110005090AMedicaidMA
110231848OtherRAILROAD MEDI
405620OtherRIBLUE CHIP
9022203MedicaidRI
000000037167OtherMABOSTON MEDICAL
459232OtherTUFTS
692775OtherHARVARD PILGRIM
3100290OtherUNITED
J25258OtherMABLUE CROSS
502OtherRIBLUE CROSS
7484643OtherAETNA
1305389001OtherCIGNA
4132OtherNEIGHBORHOOD HLT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060317000375 RI Practitioner - NephrologyPractitioner - Internal Medicine 3476560368 Reassigns benefits to 1 organization
I20091119000019 MA Practitioner - Nephrology 3476560368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Midwestern University, Chicago College of Osteopathic Med, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Associates IncGroup PAC ID 8426061185, 9 clinicians

Practice addresses (Care Compare)

211 Park St
Attleboro, MA 02703-3143
Phone (401) 438-5950

314 Taunton Ave
East Providence, RI 02914-2641
Phone (401) 438-5950

Hospital & facility affiliations

  • Dialysis Center of Attleboro LLC Dialysis facility, Attleboro, MA, CCN 222584
  • Dialysis Center of Johnston Dialysis facility, Johnston, RI, CCN 412514
  • Dialysis Center of Pawtucket Dialysis facility, Pawtucket, RI, CCN 412509
  • Dialysis Center of Providence Dialysis facility, Providence, RI, CCN 412510
  • Sturdy Memorial Hospital Hospital, Attleboro, MA, CCN 220008
  • The Miriam Hospital Hospital, Providence, RI, CCN 410012
  • Saint Anne'S Hospital Hospital, Fall River, MA, CCN 220020
  • Our Lady of Fatima Hospital Hospital, North Providence, RI, CCN 410005
  • Landmark Medical Center Hospital, Woonsocket, RI, CCN 410011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00502RIMDClinical Social Worker
213316MAMDNephrology Physician

Interoperability endpoints

  • Direct secure messaging: michael.thursby.1@25334.direct.athenahealth.com
  • Direct secure messaging: mthursby@kent.cernerdirect.carene.org

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 and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1669455192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 WATERMAN AVE",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029143525",
            "telephone_number": "401-438-5950",
            "fax_number": "401-435-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 WATERMAN AVE",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "02914",
            "telephone_number": "401-438-5950",
            "fax_number": "401-435-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THURSBY",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MA",
            "license": "213316",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "RI",
            "license": "00502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110005090A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDI",
            "identifier": "110231848",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "405620",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9022203",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOSTON MEDICAL",
            "identifier": "000000037167",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "459232",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "692775",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED",
            "identifier": "3100290",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "J25258",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "502",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7484643",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1305389001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HLT",
            "identifier": "4132",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Providence, RI

Sources for this page

Verify at the official NPI Registry.