Thomas John Wall, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MA10804200 Issued in NJ

Practice address

200 College Dr
Blackwood, NJ 08012-3228

Phone

(856) 536-1630

NPI assigned

Jul 5, 2017

Last updated

Aug 19, 2020By the provider in NPPES

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 NJ

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

Specialty

Family Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cooper Family Medicine PCGroup PAC ID 4284530197, 117 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cooper University Hospital Hospital, Camden, NJ, CCN 310014

Merit-based Incentive Payment System (MIPS)

Final score

99.52 of 100Reported as apm

Quality

81.58

Promoting interoperability

99.4

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: twall100342@direct.cooperhealth.edu

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.

• Cooper Family Medicine, PC

  • Family Medicine Physician
  • Cherry Hill, NJ
  • NPI 1649217175
  Medicare reassignment Care Compare group NPD
• Camcare Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Camden, NJ
  • NPI 1790857696
  Medicare reassignment NPD
• Cooper Physician Offices, PA

  • Internal Medicine Physician
  • Camden, NJ
  • NPI 1154369510
  Medicare reassignment NPD
• Camcare Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Clementon, NJ
  • NPI 1508035064
  NPD
• Camcare Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Camden, NJ
  • NPI 1912179953
  NPD
• Centrastate Medical Center Inc.

  • Psychiatric Hospital Unit
  • Freehold, NJ
  • NPI 1982636270
  NPD (past)
• Kennedy University Hospital Inc.

  • General Acute Care Hospital
  • Stratford, NJ
  • NPI 1386746592
  NPD (past)
• The Cooper Health System

  • General Acute Care Hospital
  • Camden, NJ
  • NPI 1568442309
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Cooper Health System

  dba Cooper University Hospital

  • Land Ambulance
  • Camden, NJ
  • NPI 1174976724

  Hospital

  Care Compare affiliation
• The Cooper Health System

  • General Acute Care Hospital
  • Camden, NJ
  • NPI 1568442309
  Care Compare affiliation

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1952822595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 COLLEGE DR",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080123228",
            "telephone_number": "856-536-1630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "THOMAS",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-05",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA10804200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Viridiana Villasenor, LAMFT
• Vital Minds Psychotherapy & Life Coaching, LLC
• Voca Corporation of New Jersey
• Voca Corporation of New Jersey
• Walgreen Co (Walgreens #01531)
• Walter M Schmidt RPT, PA
• Washington Township LV Dental LLC
• Lashante Dianne Watkins, CNA
• Lori L Watson, MSW LSW
• Westside Home Care LLC

• Family Medicine Physician in Blackwood, NJ
• Providers in Blackwood, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.