Theodore Rohan Thomas III, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA61012347 Issued in WA

Practice address

1615 Delaware St
Longview, WA 98632-2367

Phone

(360) 414-2000

NPI assigned

Aug 28, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

87.3 of 100Reported as group

Quality

70.94

Improvement activities

40

Cost

92.94

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Cep America LLC

  dba Vituity

  • Emergency Medicine Physician
  • Edmonds, WA
  • NPI 1447484274
  Medicare reassignment
• Cep America LLC

  • Emergency Medicine Physician
  • Friday Harbor, WA
  • NPI 1962200790
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD
• Washington Center for Pain Management PLLC

  • Clinic/Center
  • Lacey, WA
  • NPI 1801450952
  NPD (past)

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676073600000",
    "number": "1902387863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 DELAWARE ST",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322367",
            "telephone_number": "360-414-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 DELAWARE ST",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322367",
            "telephone_number": "360-414-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "THEODORE",
        "middle_name": "ROHAN",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-28",
        "last_updated": "2023-02-11",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61012347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Akeyla Dawn Thill, LPN
• Ashley Amber Thomas-Velikokhatko
• Carolyn Thomas, MS
• Jayme L Thomas, COTA/L
• Sharon Thomas, MA
• Deja Thompson, MSW, LICSWA
• James Harold Thompson, PTA
• Kasie Thompson
• Marlyce D Thompson, RN
• Mark R Thorson, MD

• Physician Assistant in Longview, WA
• Providers in Longview, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2023; 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.