NPIMap

Individual provider Active NPI

Thomas Lee Bostwick, MD

  • Emergency Medicine Physician
  • San Pedro, CA
National Provider Identifier
1932185220
Registry record updated Oct 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
22927 Issued in AZ
Practice address
1001 S Seaside Ave
San Pedro, CA 90731-7333
Phone
(310) 732-7500
NPI assigned
Dec 19, 2005
Last updated
Oct 7, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 22927 AZ Primary

Addresses

Primary practice location

1001 S Seaside Ave
San Pedro, CA 90731-7333

Mailing address

7507 E Farmdale Ave
Mesa, AZ 85208-2762
Phone (310) 732-7505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20090707000287 AZ Practitioner - Emergency Medicine 8628129525 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of California, Geffen School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empower St Josephs PLLCGroup PAC ID 2961866173, 52 clinicians

Practice addresses (Care Compare)

350 W Thomas Rd
Phoenix, AZ 85013-4409
Phone (602) 406-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22927AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Nov 1, 2014 Accepting new patients
District Medical Group, Inc Emergency Medicine CurrentSince Nov 1, 2014 Accepting new patients
Empower St Josephs PLLC Emergency Medicine CurrentSince Oct 1, 2023 Accepting new patients
Emergency Group of Arizona Professional Corporation Emergency Medicine CurrentSince Feb 1, 2013 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Emergency Physicians Professional Association LTD Emergency Medicine Past Accepting new patients
US Coast Guard Finance Center Past Accepting new patients
North Valley Emergency Specialists Emergency Medicine Past Accepting new patients
District Medical Group, Inc Past Accepting new patients
Isc San Pedro Blasser Clinic Past Accepting new patients

Locations

18701 N 67th Ave
Glendale, AZ 85308
Phone (623) 561-1000

7300 N 99th Ave
Glendale, AZ 85307
Phone (480) 339-5001

1930 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 532-1000

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001

5102 W Campbell Ave
Phoenix, AZ 85031
Phone (623) 848-5000

14818 N 74th St
Scottsdale, AZ 85260
Phone (480) 339-5088

Organizations & group practices 10

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 4

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": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1932185220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7507 E FARMDALE AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852082762",
            "telephone_number": "310-732-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S SEASIDE AVE",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907317333",
            "telephone_number": "310-732-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTWICK",
        "first_name": "THOMAS",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "22927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

Verify at the official NPI Registry.