Giddel G a Thom, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD2009-0687 Issued in NM

Practice address

1515 W Fir St
Portales, NM 88130-5703

Phone

(575) 356-6695

Fax

(575) 356-5948

NPI assigned

Aug 16, 2007

Last updated

Aug 26, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NM

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• La Casa de Buena Salud Inc.

  dba La Casa Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Portales, NM
  • NPI 1972603165
  Medicare reassignment NPD
• La Casa de Buena Salud Inc

  dba La Casa Community Behavioral Health Services

  • Community/Behavioral Health Agency
  • Roswell, NM
  • NPI 1538555040
  NPD
• La Casa de Buena Salud Inc

  dba La Casa School Based Clinic

  • Federally Qualified Health Center (FQHC)
  • Clovis, NM
  • NPI 1760788137
  NPD
• La Casa de Buena Salud Inc

  dba La Casa Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Roswell, NM
  • NPI 1215037379
  NPD (past)
• Presbyterian Healthcare Services

  dba Plains Regional Medical Center

  • Rural Acute Care Hospital
  • Clovis, NM
  • NPI 1629053509
  NPD (past)

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1700078375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881300843",
            "telephone_number": "575-356-6695",
            "fax_number": "575-356-5948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 W FIR ST",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881305703",
            "telephone_number": "575-356-6695",
            "fax_number": "575-356-5948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOM",
        "first_name": "GIDDEL",
        "middle_name": "G A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-16",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "MD2009-0687",
            "primary": true
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "FL",
            "license": "ME978766",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "NM",
            "license": "MD2009-0687",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENCE",
            "identifier": "ME98766",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "73252875",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruben Tellez
• Ernestine Anne Tennefos, M.A., LPCC
• Ali May Terry
• Jessica Dianne Terry
• The Psychiatric Care Center LLC
• Peter L Thompson, D.D.S.
• Martha Slemp Thorsen, CNP
• Thrive Therapy
• Chritina Timsuren
• Eva F Toelle, CNP

• Pediatrics Physician in Portales, NM
• Providers in Portales, NM by specialty
• Pediatrics Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.