NPIMap

Individual provider Active NPI

Ira Mervyn Thal, MD

  • Internal Medicine Physician
  • West Chester, PA
National Provider Identifier
1881621878
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD044987L Issued in PA
Practice address
1361 E Boot Rd
West Chester, PA 19380-5934
Phone
(484) 653-1416
Fax
(484) 653-1414
NPI assigned
Jun 27, 2006
Last updated
Sep 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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 MD044987L PA Primary

Addresses

Primary practice location

1361 E Boot Rd
West Chester, PA 19380-5934

Mailing address

PO Box 376
Newtown Square, PA 19073-0376
Phone (484) 653-1416

Other identifiers 6

IdentifierTypeStateIssuer
0560080000OtherKEYSTONE
1413362OtherPERSONAL CHOICE
110241724OtherRAILROAD MEDICARE
810561286OtherCIGNA
TH1413362OtherBLUE SHIELD
4339125OtherAETNA PPO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040802001006 PA Practitioner - Internal Medicine 8123099454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Miami, LM Miller School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ira M. Thal, MD, PCGroup PAC ID 3678544921, 2 clinicians

Practice addresses (Care Compare)

1361 E Boot Rd
West Chester, PA 19380-5934
Phone (484) 653-1416

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ira M Thal, MD, PC Internal Medicine CurrentSince Sep 15, 2024 Accepting new patients
Ira M. Thal, MD, PC Internal Medicine CurrentSince Aug 1, 2002 Accepting new patients

Locations

255 W Lancaster Ave
Ste 202
Paoli, PA 19301
Phone (484) 653-1416

1361 E Boot Rd
West Chester, PA 19380
Phone (484) 653-1200

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hospice Compassus- PhiladelphiaNewtown Square, PA, CCN 391604 Hospice Contracted Managing Employee Sep 9, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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 10

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1881621878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 376",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190730376",
            "telephone_number": "484-653-1416",
            "fax_number": "484-653-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1361 E BOOT RD",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193805934",
            "telephone_number": "484-653-1416",
            "fax_number": "484-653-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAL",
        "first_name": "IRA",
        "middle_name": "MERVYN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD044987L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "0560080000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CHOICE",
            "identifier": "1413362",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110241724",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "810561286",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "TH1413362",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4339125",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, PA

Sources for this page

Verify at the official NPI Registry.