Individual provider Active NPI

Thomas Neubauer, MD

  • Sports Medicine (Family Medicine) Physician
  • Fort Carson, CO
National Provider Identifier
1912388968
Registry record updated Aug 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
285105 Issued in NY
Practice address
1650 Cochrane Cir Unit Meddac
Fort Carson, CO 80913-4604
Phone
(719) 526-7772
NPI assigned
Jun 16, 2015
Last updated
Aug 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 285105 NY
Sports Medicine (Family Medicine) Physician 207QS0010X 285105 NY Primary

Addresses

Primary practice location

1650 Cochrane Cir Unit Meddac
Fort Carson, CO 80913-4604

Mailing address

1650 Cochrane Cir Unit Meddac
Fort Carson, CO 80913-4604
Phone (719) 526-7000

Other identifiers 1

IdentifierTypeStateIssuer
1912388968MedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20180718003731 NY Order and Referring Only - Family PracticePractitioner - Family Practice 9436406618

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723852800000",
    "number": "1912388968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR UNIT MEDDAC",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134604",
            "telephone_number": "719-526-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR UNIT MEDDAC",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134604",
            "telephone_number": "719-526-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUBAUER",
        "first_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-16",
        "last_updated": "2024-08-17",
        "certification_date": "2024-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "285105",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NY",
            "license": "285105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912388968",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Carson, CO

Sources for this page

Verify at the official NPI Registry.