Individual provider Active NPI

Sheku Richard Thomas, NP

  • Acute Care Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1790334241
Registry record updated Sep 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
R180781 Issued in MD
Practice address
3500 Boston St
Baltimore, MD 21224-5251
Phone
(443) 266-3943
NPI assigned
Sep 7, 2019
Last updated
Sep 7, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN1024901 DC
Gerontology Nurse Practitioner 363LG0600X R180781 MD
Gerontology Nurse Practitioner 363LG0600X RN1024901 DC
Acute Care Nurse Practitioner 363LA2100X R180781 MD Primary

Addresses

Primary practice location

3500 Boston St
Baltimore, MD 21224-5251

Mailing address

3500 Boston St
Baltimore, MD 21224-5251

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191113000884 MD Practitioner - Nurse Practitioner 6608208608 Reassigns benefits to 1 organization
I20211015000861 DC Practitioner - Nurse Practitioner 6608208608 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

110 Irving St NW
Washington, DC 20010-3017
Phone (202) 877-7000

25500 Point Lookout Rd
Leonardtown, MD 20650-2015
Phone (240) 434-4088

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN1024901DCMDAcute Care Nurse Practitioner
R180781MDMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Dec 30, 2023 Accepting new patients
Medstar Medical Group II LLC CurrentSince Dec 30, 2023 Accepting new patients
Advanced Spine and Pain PLLC Past Accepting new patients
Advanced Spine and Pain Centers, PLLC PastSince Oct 1, 2019 Accepting new patients

Locations

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300

25500 Point Lookout Rd
Leonardtown, MD 20650
Phone (301) 475-6106

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 1

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": "1567814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567814400000",
    "number": "1790334241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 BOSTON ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212245251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 BOSTON ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212245251",
            "telephone_number": "443-266-3943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "SHEKU",
        "middle_name": "RICHARD",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-07",
        "last_updated": "2019-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "DC",
            "license": "RN1024901",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R180781",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "DC",
            "license": "RN1024901",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MD",
            "license": "R180781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.