Tyler Joseph Thompson, DO

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

20A20365 Issued in CA

Practice address

1800 N California St
Stockton, CA 95204-6019

Phone

(209) 547-5716

NPI assigned

Jun 1, 2019

Last updated

Nov 28, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

General Practice

Education

Western Un of HLTH Sciences, Col of Podiatric Med, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Progressive Care Medical Group PLLCGroup PAC ID 7113298209, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Extended Home Care Home health agency, Brooklyn, NY, CCN 337414
• The Hamlet Rehabilitation and Healthcare Center at Nursing home, Nesconset, NY, CCN 335674

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Progressive Care Medical Group, PLLC

  • Internal Medicine Physician
  • New York, NY
  • NPI 1295263796

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Southwest Suffolk Medical, P.C.

  • Surgical Oncology Physician
  • Smithtown, NY
  • NPI 1104096049

  Multi-Specialty

  Medicare reassignment NPD
• Southwest Suffolk Medical PC

  dba Samaritan Primary Care

  • Family Medicine Physician
  • Lindenhurst, NY
  • NPI 1770919763

  Multi-Specialty

  NPD
• Southwest Suffolk, P.C

  dba Siena Proactive Internal Medicine

  • Family Medicine Physician
  • Smithtown, NY
  • NPI 1730428467
  NPD
• Nesconset Operating LLC

  • Skilled Nursing Facility
  • Nesconset, NY
  • NPI 1518485952
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Extended Nursing Personnel Chha, LLC

  dba Extended Home Care

  • Home Health Agency
  • Brooklyn, NY
  • NPI 1396836219
  Care Compare affiliation
• Nesconset Operating LLC

  • Skilled Nursing Facility
  • Nesconset, NY
  • NPI 1518485952

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1559347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1770141004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046019",
            "telephone_number": "209-547-5716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046019",
            "telephone_number": "209-547-5716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "TYLER",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-01",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "20A20365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.dignityhealth.org/central-california/locations/stjosephs-stockton/for-physicians/residen",
            "affiliation": "N",
            "address_1": "1800 N California St",
            "city": "Stockton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "952046019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.westernu.edu/",
            "affiliation": "Y",
            "affiliationName": "Western University of Health Sciences",
            "address_1": "309 E 2nd St",
            "city": "Pomona",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917661854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ronald M Thompson, SUDRC 15413
• Ruth Chevonne Thompson
• Scott Whittle Thompson, SUDCC
• Suzanne Thompson
• Thomecia Thompson
• Vanessa Rose Thompson
• Willie Thompson
• Dannica Isabelle Thomson, LCSW 115171
• Naudya Chantida Thonesavan
• Juliana Thong, DO

• General Practice Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.