Individual provider Active NPI

Thomas M Seaworth, MD

  • Family Medicine Physician
  • New York Mills, MN
National Provider Identifier
1750302972
Registry record updated May 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35090 Issued in MN
Practice address
20 Centennial 84 Dr W
New York Mills, MN 56567
Phone
(218) 385-2555
NPI assigned
Jul 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35090 MN Primary

Addresses

Primary practice location

20 Centennial 84 Dr W
New York Mills, MN 56567

Mailing address

20 Centennial 84 Dr W
New York Mills, MN 56567
Phone (218) 385-2555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20100422001165 MN Practitioner - Family Practice 0345377347 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35090MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Perham Hospital District CurrentSince Apr 14, 2020 Accepting new patients
Perham Hospital District CurrentSince Apr 14, 2020 Accepting new patients
Perham Hospital District Current Accepting new patients
Perham Hospital District Family Medicine Current Accepting new patients

Locations

105 Otter Dr
Ottertail, MN 56571
Phone (218) 367-6111

1000 Coney St W
Perham, MN 56573
Phone (218) 347-1200

Organizations & group practices 4

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": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336608000000",
    "number": "1750302972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CENTENNIAL 84 DR W",
            "city": "NEW YORK MILLS",
            "state": "MN",
            "postal_code": "56567",
            "telephone_number": "218-385-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CENTENNIAL 84 DR W",
            "city": "NEW YORK MILLS",
            "state": "MN",
            "postal_code": "56567",
            "telephone_number": "218-385-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEAWORTH",
        "first_name": "THOMAS",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2012-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "35090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York Mills, MN

Sources for this page

Verify at the official NPI Registry.