Individual provider Active NPI

Bradley Joseph Thobe, MD

  • Family Medicine Physician
  • Urbana, IL
National Provider Identifier
1871021584
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036150856 Issued in IL
Practice address
611 W Park St
Urbana, IL 61801-2529
Phone
(217) 258-7590
Fax
(217) 258-3686
NPI assigned
May 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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 125070619 IL
Family Medicine Physician 207Q00000X 036150856 IL Primary

Addresses

Primary practice location

611 W Park St
Urbana, IL 61801-2529

Mailing address

611 W Park St
Fapc
Urbana, IL 61801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20201221001657 IL Practitioner - Family Practice 8022378355 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

1701 W Curtis Rd
Champaign, IL 61822-9678
Phone (217) 365-6200

1818 E Windsor Rd
Urbana, IL 61802-9566
Phone (217) 255-9500

611 W Park St
Urbana, IL 61801-2500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036150856ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Care Incorporated Family Medicine CurrentSince Oct 12, 2020 Accepting new patients
Hoopeston Community Memorial Hospital Current Accepting new patients
Hoopeston Community Memorial Hospital Family Medicine Current Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Oct 12, 2020 Accepting new patients
Carle Health Care Incorporated Past Accepting new patients

Locations

701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531

2512 Hurst Dr
Ste 120
Mattoon, IL 61938
Phone (217) 258-5900

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

1818 E Windsor Rd
Urbana, IL 61802
Phone (217) 255-9646

Interoperability endpoints

  • Direct secure messaging: bthobemd316531@carlehiedirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1871021584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012529",
            "telephone_number": "217-258-7590",
            "fax_number": "217-258-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOBE",
        "first_name": "BRADLEY",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-24",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125070619",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036150856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

Verify at the official NPI Registry.