Thomas Duckett, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

G58176 Issued in CA

Practice address

500 Doyle Park Dr Ste 303
Santa Rosa, CA 95405-4559

Phone

(707) 575-1833

Fax

(707) 575-3561

NPI assigned

Jul 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tduckett26229@hisp.ehr.sutterhealth.org

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.

• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment NPD
• Sutter Bay Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• North Coast Faculty Medical Group Inc

  • Otolaryngology Physician
  • Sebastopol, CA
  • NPI 1750616512
  NPD (past)
• Santa Rosa Trauma Physicians Medical Group

  • Trauma Surgery Physician
  • Santa Rosa, CA
  • NPI 1184673162
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790700532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 DOYLE PARK DR STE 303",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054559",
            "telephone_number": "707-575-1833",
            "fax_number": "707-575-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DOYLE PARK DR STE 303",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054559",
            "telephone_number": "707-575-1833",
            "fax_number": "707-575-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCKETT",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "G58176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G581760",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ19545Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vicente Duarte
• Elyse C Dubin, MD
• Audrey Dubour, OTR
• Carley Jean Ducharme
• Robert M. Duchynski, MD
• Robert Dudley
• Douglas Duell, MFT
• Amelia Duer-Chapman
• Alvaris W Duffis, M.D.
• Rebecca Jane Duffy, MS

• Urology Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.