Individual provider Active NPI

Eric Kirk Thoburn, MD

  • Diagnostic Radiology Physician
  • Gainesville, FL
National Provider Identifier
1700883485
Registry record updated Oct 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME0057091 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone
(352) 265-0291
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2010

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME0057091 FL
Diagnostic Radiology Physician 2085R0202X ME0057091 FL Primary
Diagnostic Ultrasound Physician 2085U0001X ME0057091 FL
Body Imaging Physician 2085B0100X ME0057091 FL
Diagnostic Neuroimaging (Radiology) Physician 2085D0003X ME0057091 FL
Nuclear Radiology Physician 2085N0904X ME0057091 FL
Pediatric Radiology Physician 2085P0229X ME0057091 FL
Neuroradiology Physician 2085N0700X ME0057091 FL
Therapeutic Radiology Physician 2085R0203X ME0057091 FL

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-3003

Mailing address

PO Box 918025
Orlando, FL 32891-8025
Phone (352) 265-0291

Other identifiers 1

IdentifierTypeStateIssuer
002668700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20040319000325 FL Practitioner - Diagnostic RadiologyPractitioner - General Surgery 3971493115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of South Florida College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1535 Gale Lemerand Dr
Gainesville, FL 32610-3008
Phone (352) 273-9500

1549 Gale Lemerand Dr
Gainesville, FL 32610-3008
Phone (352) 265-4357

1600 SW Archer
Gainesville, FL 32610-3003

1600 SW Archer Rd
Gainesville, FL 32610-3003

1600 SW Archer Rd RM
1191 Uf Health Surgical Specialists Shands
Gainesville, FL 32610-3003
Phone (352) 265-0535

2000 SW Archer Rd
Uf Health Congenital Heart Center Medical P
Gainesville, FL 32610-3003
Phone (352) 265-8250

2001 SW 13TH St
Gainesville, FL 32608-1532
Phone (352) 265-8990

3009 SW Williston Rd
Uf Health Digestive Disease Specialists Wil
Gainesville, FL 32608-3928
Phone (352) 273-9400

3450 Hull Rd
Gainesville, FL 32607-4144

3450 SW Hull Rd
Uf Health Pediatric Urology Osmi
Gainesville, FL 32607-4144
Phone (352) 265-8240

3480 Hull Rd
Gainesville, FL 32607-4144
Phone (352) 338-7100

4037 NW 86TH Ter
FL 3
Gainesville, FL 32606-9277
Phone (352) 265-7777

4037 NW 86TH Terr 2ND Floor
Gainesville, FL 32606-9277

4037 NW 86TH Terr Floor
Gainesville, FL 32606-9277

6201 W Newberry Rd
Uf Health the Oaks
Gainesville, FL 32605-4305
Phone (352) 265-9465

Uf Health Test Site Pop Up 1600 SW Ar
Gainesville, FL 32610-3003
Phone (352) 392-1161

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0057091FLMDTherapeutic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc Surgery CurrentSince Jul 1, 2010 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jul 1, 2010 Accepting new patients

Locations

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: ethoburn15517@direct.shands.ufl.edu

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.

Hospital & facility affiliations 8

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286928000000",
    "number": "1700883485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 918025",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328918025",
            "telephone_number": "352-265-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-265-0291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOBURN",
        "first_name": "ERIC",
        "middle_name": "KIRK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2010-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME0057091",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME0057091",
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "FL",
            "license": "ME0057091",
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "FL",
            "license": "ME0057091",
            "primary": false
        },
        {
            "code": "2085D0003X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": "FL",
            "license": "ME0057091",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "FL",
            "license": "ME0057091",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "FL",
            "license": "ME0057091",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "FL",
            "license": "ME0057091",
            "primary": false
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "FL",
            "license": "ME0057091",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002668700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.