Thomas W Tully Jr.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

102657 Issued in FL

Practice address

615 N Bonita Ave
Panama City, FL 32401-3623

Phone

(850) 747-6000

NPI assigned

Mar 8, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WI, NY2 enrollments

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 2

Specialty

Emergency MedicineAlso: Internal Medicine

Education

Loyola University of Chicago, Stritch School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Physician Associates of Wisconsin SCGroup PAC ID 3577865690, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Oswego Hospital Hospital, Oswego, NY, CCN 330218
• Watertown Memorial Hospital Hospital, Watertown, WI, CCN 520116
• Langlade Hospital Hospital, Antigo, WI, CCN 521350

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ttully@oswegohealth.hiemail.healtheconnections.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.

• Emergency Physician Associates of Wisconsin SC

  • Emergency Medicine Physician
  • Marinette, WI
  • NPI 1396119426
  Medicare reassignment Care Compare group NPD
• Langlade Hospital - Hotel Dieu of St Joseph of Antigo Wisconsin

  • Rural Health Clinic/Center
  • Elcho, WI
  • NPI 1831251040
  Medicare reassignment NPD
• Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin

  • Critical Access Hospital
  • Antigo, WI
  • NPI 1639187412

  Emergency Medicine

  Medicare reassignment NPD
• Port City Emergency Physicians LLP

  • Emergency Medicine Physician
  • Oswego, NY
  • NPI 1134370547
  Medicare reassignment NPD
• Thedacare Medical Center - New London, Inc.

  • Critical Access Hospital
  • New London, WI
  • NPI 1538127220
  Medicare reassignment NPD
• Thedacare Medical Center - Shawano, Inc.

  • Critical Access Hospital
  • Shawano, WI
  • NPI 1548260839
  Medicare reassignment NPD
• Thedacare Medical Center - Waupaca, Inc.

  • Critical Access Hospital
  • Waupaca, WI
  • NPI 1710333893
  Medicare reassignment NPD
• Aspirus Medical Group, Inc.

  • Clinic/Center
  • Rhinelander, WI
  • NPI 1679757751
  NPD
• Port City Emergency Physicians LLP

  • Emergency Medicine Physician
  • Hamilton, NY
  • NPI 1316395460
  NPD
• Thedacare Medical Center - New London, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • New London, WI
  • NPI 1639182926
  NPD
• Thedacare Medical Center - Shawano, Inc.

  • Community/Retail Pharmacy
  • Shawano, WI
  • NPI 1306516604
  NPD
• Advance Technological Radiology, PA

  • Diagnostic Radiology Physician
  • Davenport, FL
  • NPI 1154450351
  NPD (past)

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

• Langlade Hospital - Hotel Dieu of St Joseph of Antigo Wisconsin

  • Rural Health Clinic/Center
  • Antigo, WI
  • NPI 1821151366

  Hospital

  Care Compare affiliation
• Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin

  • Critical Access Hospital
  • Antigo, WI
  • NPI 1639187412
  Care Compare affiliation
• Oswego Hospital

  • General Acute Care Hospital
  • Oswego, NY
  • NPI 1871678458
  Care Compare affiliation
• Watertown Medical Center LLC

  • General Acute Care Hospital
  • Watertown, WI
  • NPI 1992776041
  Care Compare affiliation

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1851369664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 N BONITA AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013623",
            "telephone_number": "850-747-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N BONITA AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013623",
            "telephone_number": "850-747-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLY",
        "first_name": "THOMAS",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00033876",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "102657",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "42410-20",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8195596",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD RIDER",
            "identifier": "M18541",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930103921",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elzaan Truter
• Michelle Faucheux Trzeciak
• Jeremy Tseng, MD
• Chelsea Tucker
• Jason Glenn Tucker, LMHC
• Maciej Tumiel, M.D.
• Benjamin James Turnbow, MD
• Becky Jean Turner-Sanders, RBT
• Britton Turner
• Kara Boudreaux Turner, MSN,CPNP

• Emergency Medicine Physician in Panama City, FL
• Providers in Panama City, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; 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.