Active NPI
Thomas Glenn Elias Jr., M.D.
- Occupational Medicine Physician
- San Diego, CA
National Provider Identifier
1710092184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Medicine Physician
- License
- G45571
- Practice address
- 2020 Genesee Ave
San Diego, CA 92123-4219 - Phone
- (858) 616-8400
- Fax
- (858) 569-0741
- NPI assigned
- Aug 19, 2006
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | G45571 | CA | |
| Occupational Medicine Physician | 2083X0100X | G45571 | CA | Primary |
Addresses
Primary practice location
2020 Genesee Ave
San Diego, CA 92123-4219
Mailing address
2020 Genesee Ave
San Diego, CA 92123-4219
Phone (858) 616-8400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G455710 | Medicaid | CA |
Other names 1
- T. Glenn Elias
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G45571 | CA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sharp Rees-Stealy Medical Group, Inc | Emergency Medicine | Past | Accepting new patients |
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.
-
- Internal Medicine Physician
- San Diego, CA
- NPI 1285616177
Emergency Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371600000000",
"number": "1710092184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2020 GENESEE AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234219",
"telephone_number": "858-616-8400",
"fax_number": "858-569-0741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 GENESEE AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234219",
"telephone_number": "858-616-8400",
"fax_number": "858-569-0741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELIAS",
"first_name": "THOMAS",
"middle_name": "GLENN",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-19",
"last_updated": "2013-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "G45571",
"primary": false
},
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "CA",
"license": "G45571",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G455710",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "T.",
"last_name": "ELIAS",
"middle_name": "GLENN",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.