NPIMap

Individual provider Active NPI

Matthew W. Thoms, P.A.-C

  • Physician Assistant
  • Enid, OK
National Provider Identifier
1710974506
Registry record updated Feb 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1103 Issued in OK
Practice address
707 S Monroe St
Enid, OK 73701-7286
Phone
(580) 616-7630
Fax
(580) 237-7516
NPI assigned
Oct 5, 2005
Last updated
Feb 12, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1103 OK Primary

Addresses

Primary practice location

707 S Monroe St
Enid, OK 73701-7286

Mailing address

5300 N Independence Ave
280
Oklahoma City, OK 73112-5556
Phone (580) 616-7630

Other identifiers 2

IdentifierTypeStateIssuer
100210100AMedicaidOK
P01318823OtherOKRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060614000316 OK Practitioner - Physician Assistant 0244242162 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integris Cardiovascular Physicians LLCGroup PAC ID 3577730068, 116 clinicians

Practice addresses (Care Compare)

3433 NW 56TH St
Suite 760
Oklahoma City, OK 73112-4461
Phone (405) 951-4345

707 S Monroe St
Integris Heart and Vascular NW
Enid, OK 73701-7286
Phone (580) 616-7634

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Bass Baptist Health Center Past Accepting new patients
Cardiology Services of Enid Past Accepting new patients
Integris Rural Health Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mthoms9170@direct.integrisok.com

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518393600000",
    "number": "1710974506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "580-616-7630",
            "fax_number": "580-237-7516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S MONROE ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737017286",
            "telephone_number": "580-616-7630",
            "fax_number": "580-237-7516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMS",
        "first_name": "MATTHEW",
        "middle_name": "W.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2018-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100210100A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01318823",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

Verify at the official NPI Registry.