Thomas E Stark, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

44537-021 Issued in WI

Practice address

644 Naples St
Chula Vista Naval Branch Clinic
Chula Vista, CA 91911-1636

Phone

(619) 744-5355

NPI assigned

Apr 22, 2006

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

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• St. Marys Dean Ventures Inc.

  • Clinic/Center
  • Baraboo, WI
  • NPI 1811944093
  NPD
• Dean Health Systems, Inc,

  • Durable Medical Equipment & Medical Supplies
  • Beaver Dam, WI
  • NPI 1336425016
  NPD (past)

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

{
    "created_epoch": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457654400000",
    "number": "1912963513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "644 NAPLES STREET",
            "address_2": "NAVAL BRANCH CLINIC CHULA VISTA",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "91911",
            "telephone_number": "619-744-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "644 NAPLES ST",
            "address_2": "CHULA VISTA NAVAL BRANCH CLINIC",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919111636",
            "telephone_number": "619-744-5355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "THOMAS",
        "middle_name": "E",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-22",
        "last_updated": "2016-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "44537-021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS PLUS",
            "identifier": "1040755",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43500700",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH INSURANCE",
            "identifier": "60052",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maggie Stake, M.S. CCC-SLP
• Kaulauni Stambaugh
• Jelena Stankovic Alic
• Stanmore G Langford III DC a Chiropractic Prof Corporation
• Letitia Antoinette Stanton-Aicher, MS, CCC-SLP
• Stars Speech Inc.
• Sarah Elizabeth Staten, OTR/L
• Stayhome Care Solutions, Inc.
• Carli Steele, FNP
• Gregory M Steele, O.D.

• Family Medicine Physician in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.