Individual provider Active NPI

Thomas Joseph Duralde, MD

  • Family Medicine Physician
  • Hawthorne, CA
National Provider Identifier
1982644043
Registry record updated Nov 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G52204 Issued in CA
Practice address
5400 W Rosecrans Ave
Suite 100
Hawthorne, CA 90250-6609
Phone
(310) 727-1723
Fax
(310) 643-9707
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2012

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 G52204 CA Primary

Addresses

Primary practice location

5400 W Rosecrans Ave
Suite 100
Hawthorne, CA 90250-6609

Mailing address

5400 W Rosecrans Ave
Hawthorne, CA 90250-6609
Phone (310) 727-1723

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040505001577 CA Practitioner - Family Practice 7719975887 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G52204CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 1, 2004 Accepting new patients
Healthcare Partners Affiliates Medical Group Family Medicine CurrentSince Jan 1, 2004 Accepting new patients

Locations

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

5400 W Rosecrans Ave
Hawthorne, CA 90250
Phone (310) 643-8500

5400 W Rosecrans Ave
Ste 100
Hawthorne, CA 90250
Phone (310) 643-8500

601 Torrance Blvd
#1182
Redondo Beach, CA 90277

Organizations & group practices 2

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352073600000",
    "number": "1982644043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 W ROSECRANS AVE",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902506609",
            "telephone_number": "310-727-1723",
            "fax_number": "310-536-0495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 W ROSECRANS AVE",
            "address_2": "SUITE 100",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902506609",
            "telephone_number": "310-727-1723",
            "fax_number": "310-643-9707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURALDE",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2012-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G52204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

Verify at the official NPI Registry.