Individual provider Active NPI

Hilton Tellis Thomas, PHD

  • Psychologist
  • Lansing, MI
National Provider Identifier
1700073228
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301003971 Issued in MI
Practice address
302 S Waverly Rd
Suite 1
Lansing, MI 48917-3631
Phone
(517) 321-5900
Fax
(517) 321-5945
NPI assigned
Sep 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301003971 MI Primary

Addresses

Primary practice location

302 S Waverly Rd
Suite 1
Lansing, MI 48917-3631

Mailing address

302 S Waverly Rd
Suite 1
Lansing, MI 48917-3631
Phone (517) 321-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101217000208 MI Practitioner - Clinical Psychologist 6305034315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Meridian Professional Psychological ConsultantsGroup PAC ID 5193880284, 15 clinicians

Practice addresses (Care Compare)

5031 Park Lake Rd
East Lansing, MI 48823-3835
Phone (517) 332-0811

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6301003971MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Psychological and Rehabilitation Services, PC Current Accepting new patients
Meridian Professional Psychological Consultants CurrentSince Nov 22, 2010 Accepting new patients

Locations

5031 Park Lake Rd
East Lansing, MI 48823
Phone (517) 332-0811

3815 W Saint Joseph St
Ste A101
Lansing, MI 48917
Phone (517) 321-5900

302 S Waverly Rd
Ste 1
Lansing, MI 48917
Phone (517) 321-5900

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.

NPI Registry JSON

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190937600000",
    "number": "1700073228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 S WAVERLY RD",
            "address_2": "SUITE 1",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489173631",
            "telephone_number": "517-321-5900",
            "fax_number": "517-321-5945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 S WAVERLY RD",
            "address_2": "SUITE 1",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489173631",
            "telephone_number": "517-321-5900",
            "fax_number": "517-321-5945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "HILTON",
        "middle_name": "TELLIS",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-28",
        "last_updated": "2007-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301003971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.