Individual provider Active NPI

Thomas Reece, DO

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • San Rafael, CA
National Provider Identifier
1881722247
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X
License
20A8247CA Issued in CA
Practice address
25 Mitchell Blvd
San Rafael, CA 94903-2007
Phone
(415) 472-2343
Fax
(415) 472-7636
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X 20A8247CA CA Primary

Addresses

Primary practice location

25 Mitchell Blvd
San Rafael, CA 94903-2007

Mailing address

25 Mitchell Blvd
San Rafael, CA 94903-2007
Phone (415) 472-2343

Other identifiers 1

IdentifierTypeStateIssuer
20A8247CAOtherCALICENSE

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
I20110314000819 CA Practitioner - Family Practice 5092997965 Practice locations: San Rafael, CA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4340 Redwood Hwy A22
San Nafael, CA 94903-2013

4340 Redwood Hwy A22
San Rafael, CA 94903-2121
Phone (415) 472-2343

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A8247CACAMDSports Medicine (Neuromusculoskeletal Medicine) Physician
2753AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rasnow Integrative Wellness Inc Past Accepting new patients

Organizations & group practices 1

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 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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881722247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MITCHELL BLVD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032007",
            "telephone_number": "415-472-2343",
            "fax_number": "415-472-7636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MITCHELL BLVD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032007",
            "telephone_number": "415-472-2343",
            "fax_number": "415-472-7636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REECE",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "CA",
            "license": "20A8247CA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "20A8247CA",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

Verify at the official NPI Registry.