Individual provider Active NPI

Toms Vengaloor Thomas, M.D

  • Radiation Oncology Physician
  • Jackson, MS
National Provider Identifier
1962817445
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
2023010279 Issued in MO
Practice address
350 W Woodrow Wilson Ave Dept of
Jackson, MS 39213-7681
Phone
(601) 984-1000
NPI assigned
Jun 24, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 2023010279 MO Primary
Radiation Oncology Physician 2085R0001X 27671 MS

Addresses

Primary practice location

350 W Woodrow Wilson Ave Dept of
Jackson, MS 39213-7681

Mailing address

408 Emerald TRL
Brandon, MS 39047-6511

Other practice location 1

1701 Lacey St
Cape Girardeau, MO 63701-5230
Phone (573) 334-4822

Other practice location 2

2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-1000

Other practice location 3

789 S Mount Auburn Rd
Cape Girardeau, MO 63703-6387
Phone (573) 519-4800

Other names 1

  • Toms V Thomas Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20230929001796 MO Practitioner - Radiation Oncology 6507268224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

789 S Mount Auburn Rd
Cape Girardeau, MO 63703-6387
Phone (573) 519-4830

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
67.75
Promoting interoperability
100
Improvement activities
40
Cost
71.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023010279MOMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Missouri Hospital Physicians, LLC CurrentSince Sep 1, 2023 Accepting new patients

Locations

789 S Mount Auburn Rd
Cape Girardeau, MO 63703
Phone (573) 519-4800

789 S Mount Auburn Rd
Ste E
Cape Girardeau, MO 63703

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

Interoperability endpoints

  • Direct secure messaging: tthomas56598@ummc.direct-ci.com

Organizations & group practices 1

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 6

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": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1962817445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 EMERALD TRL",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390476511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W WOODROW WILSON AVE DEPT OF",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392137681",
            "telephone_number": "601-984-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 Lacey St",
            "address_purpose": "LOCATION",
            "city": "Cape Girardeau",
            "state": "MO",
            "postal_code": "637015230",
            "country_code": "US",
            "telephone_number": "573-334-4822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 N State St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164500",
            "country_code": "US",
            "telephone_number": "601-984-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "789 S Mount Auburn Rd",
            "address_purpose": "LOCATION",
            "city": "Cape Girardeau",
            "state": "MO",
            "postal_code": "637036387",
            "country_code": "US",
            "telephone_number": "573-519-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VENGALOOR THOMAS",
        "first_name": "TOMS",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-24",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MO",
            "license": "2023010279",
            "primary": true
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MS",
            "license": "27671",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TOMS",
            "last_name": "V THOMAS",
            "credential": "M.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.