Active NPI
Thomas Gast, MD
- Diagnostic Radiology Physician
- Mishawaka, IN
National Provider Identifier
1669637153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 336075522
- Practice address
- 620 W Edison Rd
Suite 110
Mishawaka, IN 46545-2784 - Phone
- (574) 258-1100
- Fax
- (574) 259-1101
- NPI assigned
- Jul 23, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 336075522 | IL | Primary |
| Vascular & Interventional Radiology Physician | 2085R0204X | 036-112490 | IL |
Addresses
Primary practice location
620 W Edison Rd
Suite 110
Mishawaka, IN 46545-2784
Mailing address
620 W Edison Rd
Suite 110
Mishawaka, IN 46545-2784
Phone (574) 258-1100
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tgast@direct.ccprovider.org | Direct | Cook County |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1901 W Harrison St
Chicago, IL 60612-3714
Phone (312) 633-7292
500 E 51St St
Chicago, IL 60615-2494
Phone (312) 572-2000
Hospital & facility affiliations
- John H Stroger Jr Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.11 of 100
- Quality
- 74.7
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 85.45
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 336075522 | IL | MD | Diagnostic Radiology Physician |
| 036-112490 | IL | MD | Vascular & Interventional Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cook County | Current | Accepting new patients | |
| Cook County | Current | Accepting new patients | |
| Cook County | Current | Accepting new patients | |
| Radiology, Inc | Diagnostic Radiology | Past | Accepting new patients |
Locations
500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000
1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100
Interoperability endpoints
- tgast@direct.ccprovider.org
Organizations & group practices 4
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.
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- Diagnostic Radiology Physician
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Hospital & facility affiliations 27
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": "1216771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619136000000",
"number": "1669637153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 W EDISON RD",
"address_2": "SUITE 110",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465452784",
"telephone_number": "574-258-1100",
"fax_number": "574-258-1101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 W EDISON RD",
"address_2": "SUITE 110",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465452784",
"telephone_number": "574-258-1100",
"fax_number": "574-259-1101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAST",
"first_name": "THOMAS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-23",
"last_updated": "2021-04-23",
"certification_date": "2021-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": "336075522",
"primary": true
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "IL",
"license": "036-112490",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tgast@direct.ccprovider.org",
"affiliation": "Y",
"affiliationName": "Cook County",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1969 W. Ogden Ave.",
"city": "Chicago",
"state": "IL",
"country_code": "US",
"postal_code": "606123723",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Mishawaka, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; 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.