NPIMap

Individual provider Active NPI

Thomas A Sheesley, D.O.

  • Family Medicine Physician
  • West River, MD
National Provider Identifier
1841551645
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H78924 Issued in MD
Practice address
134 Owensville Road
West River, MD 20778
Phone
(410) 867-4700
Fax
(410) 867-8754
NPI assigned
Jun 7, 2012
Last updated
Nov 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X H78924 MD Primary

Addresses

Primary practice location

134 Owensville Road
West River, MD 20778

Mailing address

134 Owensville Road
West River, MD 20778
Phone (410) 867-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20160404000633 MD Practitioner - Family Practice 1759515547 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of New England, College of Osteo Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Luminis Health Medical Group, LLCGroup PAC ID 2860447315, 540 clinicians

Practice addresses (Care Compare)

3169 Braverton St
Suite 201
Edgewater, MD 21037-2690
Phone (410) 956-4911

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H78924MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC Current Accepting new patients
Owensville Primary Care, Inc Family Medicine CurrentSince Jan 17, 2016 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Jul 1, 2021 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Jul 1, 2021 Accepting new patients
Owensville Primary Care,Inc Family Medicine CurrentSince Jan 17, 2016 Accepting new patients

Locations

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

3169 Braverton St
Ste 201
Edgewater, MD 21037
Phone (410) 956-4911

134 Owensville Rd
West River, MD 20778
Phone (410) 867-4700

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 9

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": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1841551645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 OWENSVILLE ROAD",
            "city": "WEST RIVER",
            "state": "MD",
            "postal_code": "20778",
            "telephone_number": "410-867-4700",
            "fax_number": "410-867-8754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 OWENSVILLE ROAD",
            "city": "WEST RIVER",
            "state": "MD",
            "postal_code": "20778",
            "telephone_number": "410-867-4700",
            "fax_number": "410-867-8754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEESLEY",
        "first_name": "THOMAS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-07",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "H78924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West River, MD

Sources for this page

Verify at the official NPI Registry.