RICHARD JUSTIN THOMS M.D.
NPI 1194987883
Orthopaedic Surgery in Niantic, CT

Q: What is Richard Thoms's NPI number?

The NPI number for Richard Thoms is 1194987883. It was assigned to this individual provider in the NPPES registry on June 25, 2008. The provider is also known as R Justin Thoms M.D..

Q: What is Richard Thoms's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Richard Thoms was last updated on April 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 25, 2008PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

11 INDUSTRIAL PARK RD, NIANTIC, CT 06357(860) 889-7345 Get Directions Write a Review

NPPES record last updated: April 28, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Richard Justin Thoms M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RICHARD JUSTIN THOMS M.D. (NPI 1194987883) is an individual orthopaedic surgery provider in Niantic, Connecticut, licensed in Connecticut (047870) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS, is affiliated with Westerly Hospital, and maintains a secondary practice location in North Franklin.

NPPES Registry Identity

NPI1194987883

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameRICHARD JUSTIN THOMSCredential: M.D.

Location Address11 INDUSTRIAL PARK RDNiantic, CT 06357-1210

Mailing Address82 New Park AveNorth Franklin, CT 06254-1807 · (860) 889-7345

Phone(860) 889-7345

Sole ProprietorYes

Medical School CMSJs Weill Medical College, Cornell UniversityGraduated 2003

Enumeration DateJune 25, 2008

Last NPPES UpdateApril 28, 2022

NPPES CertifiedApril 28, 2022

✔ NPI 1194987883 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in CT · 047870

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

11 INDUSTRIAL PARK RD, Niantic, CT 06357

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Other Names 1

Professional Name (2)R Justin Thoms M.d.

Secondary Practice Location 1

Location 182 New Park AveNorth Franklin, CT 06254-1807 · Phone (860) 889-7345

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Richard Justin Thoms M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8628145307

PECOS Enrollment IDI20090925000279

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Richard Thoms reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Norwich Orthopedic Group, P.C.

15 mi

Orthopaedic Surgery

82 NEW PARK AVE
North Franklin, CT 06254

Reassigned Medicare billing, Connecticut enrollment
Medicare enrollment name: Norwich Orthopedic Group PC
45 clinicians in this Medicare group

NPI 1558316919 (860) 889-7345

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 17

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

376 services264 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

253 services180 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

202 services152 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

201 services162 patients

Device supply with scheduled recording and transmission for remote monitoring of musculoskeletal system, per 30 days 98977

This service involves providing a device that records and transmits data about your musculoskeletal system remotely. For 30 days, it tracks your body's musculoskeletal health, allowing for timely interventions if needed. It's a non-invasive way to monitor your health continuously.

190 services30 patients

Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702

This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.

139 services46 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

79 services75 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

66 services53 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

61 services59 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

52 services47 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

49 services49 patients

Replacement of thigh bone and hip joint with prosthesis 27130

This procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.

46 services45 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

37 services37 patients

X-ray of both hips, 3-4 views 73522

An X-ray of both hips with 3-4 views is a safe imaging procedure. It involves capturing multiple pictures of your hip joints from different angles. This helps in diagnosing conditions like arthritis or fractures. You'll need to stay still during the process for clear images.

26 services26 patients

Set-up and patient education for remote monitoring of therapy 98975

Remote therapy monitoring involves using digital devices to track your health and treatment progress from home. You'll receive a device to record health data, like heart rate or blood sugar. This data is shared with your healthcare team, allowing them to adjust your treatment as needed.

25 services23 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

18 services18 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Westerly Hospital

Acute Care Hospitals · Westerly, RI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number410013

Location25 Wells StreetWesterly, RI 02891 · Washington County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06357 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$93.86 typical visit price

range $60.82 – $183.10

Typical copayment $23.46 (range $15.20 – $45.77)

Most-billed visit code 99203

Established Patient

$75.55 typical visit price

range $19.76 – $149.26

Typical copayment $18.88 (range $4.94 – $37.31)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Walker, folding, wheeled, adjustable or fixed height E0143

DME-Other DME · category DE000N

7 suppliers37 claims37 services$48.66 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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