Individual provider Active NPI

Thomas M Whelan, M.D.

  • Family Medicine Physician
  • Brookfield, CT
National Provider Identifier
1972543692
Registry record updated Jun 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
57225 Issued in CT
Practice address
401 Federal Rd
Brookfield, CT 06804-2037
Phone
(203) 775-6365
Fax
(203) 740-3010
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 57225 CT Primary

Addresses

Primary practice location

401 Federal Rd
Brookfield, CT 06804-2037

Mailing address

401 Federal Rd
Brookfield, CT 06804-2037
Phone (203) 775-6365

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20180207001755 CT Practitioner - Family Practice 8325938459 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
57225CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
James K Ahern and Dr Carol a Galban MDS Family Medicine CurrentSince Nov 1, 2020 Accepting new patients
Corey B Johnson MD PC Family Medicine Past Accepting new patients
Southbury Medical Associates, LLP PastSince Jun 7, 2020 Accepting new patients

Locations

77 Danbury Rd
Ste 1
Ridgefield, CT 06877
Phone (203) 431-6342

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591056000000",
    "number": "1972543692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 FEDERAL RD",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042037",
            "telephone_number": "203-775-6365",
            "fax_number": "203-740-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 FEDERAL RD",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042037",
            "telephone_number": "203-775-6365",
            "fax_number": "203-740-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHELAN",
        "first_name": "THOMAS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "57225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, CT

Sources for this page

Verify at the official NPI Registry.