Individual provider Active NPI

Nicolas Thor, MD

  • Internal Medicine Physician
  • Colton, CA
National Provider Identifier
1861078545
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A193399 Issued in CA
Practice address
400 N Pepper Ave
Colton, CA 92324-1801
Phone
(909) 580-1000
NPI assigned
Mar 22, 2021
Last updated
Mar 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A193399 CA Primary

Addresses

Primary practice location

400 N Pepper Ave
Colton, CA 92324-1801

Mailing address

400 N Pepper Ave
Colton, CA 92324-1801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20250401003366 CA Practitioner - Internal Medicine 7618490426 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quantum Healthcare Medical Associates IncGroup PAC ID 5294647574, 109 clinicians
Clinic Services of California Medical Group IncGroup PAC ID 7810209715, 65 clinicians

Practice addresses (Care Compare)

1880 N Orange Grove Ave
Pomona, CA 91767-3006
Phone (909) 630-7158

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A193399CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quantum Healthcare Medical Associates Inc. Internal Medicine CurrentSince Apr 1, 2025 Accepting new patients
Clinic Services of California Medical Group Inc CurrentSince Apr 1, 2025 Accepting new patients

Locations

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800

Organizations & group practices 3

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 3

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": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1861078545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOR",
        "first_name": "NICOLAS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-22",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A193399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.