ALISHA TAWANDA THOMAS MD
NPI 1609074657
Family Medicine in Chicago, IL

NPI Status: Active since July 10, 2007

Contact Information

5425 W LAKE ST
CHICAGO, IL
ZIP 60644
Phone: (773) 378-3347
Fax: (773) 378-4028

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Durable Medical Equipment
Physician Visit Costs
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Family Medicine
Accepts Insurance
PECOS Enrolled

About ALISHA THOMAS

This page provides the complete NPI Profile along with additional information for Alisha Thomas, a primary care provider established in Chicago, Illinois with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1609074657 assigned on July 2007. The practitioner's primary taxonomy code is 207Q00000X with license number 036119977 (IL). The provider is registered as an individual and her NPI record was last updated 14 years ago.

NPI: 1609074657
Provider Name: ALISHA TAWANDA THOMAS MD
Gender: Female
Entity Type: Individual
Location Address: 5425 W LAKE ST CHICAGO, IL 60644
Location Phone: (773) 378-3347
Location Fax: (773) 378-4028
Mailing Address: 5425 W LAKE ST CHICAGO, IL 60644
Mailing Phone: (773) 378-3347
Mailing Fax: (773) 378-4028
Is Sole Proprietor?: No
Enumeration Date: 07-10-2007
Last Update Date: 03-10-2011
Code Navigator

A primary care provider (PCP) like Alisha Thomas sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Family Medicine
Taxonomy Code: 207Q00000X
Type: Allopathic & Osteopathic Physicians
License No.: 036119977
License State: IL
Taxonomy Description: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Aetna CVS Health

Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay - PPO
Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - PPO

Ambetter from Home State Health

Complete Gold - EPO
Complete Gold + Vision + Adult Dental - EPO
Complete Silver - EPO
Complete Silver + Vision + Adult Dental - EPO
Elite Bronze - EPO
Elite Bronze + Vision + Adult Dental - EPO
Everyday Bronze - EPO
Everyday Bronze + Vision + Adult Dental - EPO
Everyday Gold - EPO
Everyday Gold + Vision + Adult Dental - EPO

Ambetter Health

Choice Bronze HSA - HMO
Choice Bronze HSA + Vision + Adult Dental - HMO
Clear Silver - HMO
Complete Gold - HMO
Complete Gold + Vision + Adult Dental - HMO
Elite Bronze - HMO
Elite Bronze + Vision + Adult Dental - HMO
Elite Gold - HMO
Elite Gold + Vision + Adult Dental - HMO
Elite Silver - HMO

Ambetter Health of Delaware

Clear Gold - EPO
Clear Gold + Vision + Adult Dental - EPO
Complete Gold - EPO
Complete Gold + Vision + Adult Dental - EPO
Elite Silver - EPO
Elite Silver + Vision + Adult Dental - EPO
Everyday Bronze - EPO
Everyday Bronze + Vision + Adult Dental - EPO
Focused Silver - EPO
Focused Silver + Vision + Adult Dental - EPO

Ambetter of Illinois

Central Bronze - HMO
Central Bronze + Vision + Adult Dental - HMO
Central Gold - HMO
Central Gold + Vision + Adult Dental - HMO
Clear Silver - HMO
Everyday Bronze - HMO
Everyday Bronze + Vision + Adult Dental - HMO
Everyday Gold - HMO
Everyday Gold + Vision + Adult Dental - HMO
Focused Silver - HMO

Blue Cross and Blue Shield of Illinois

Blue Choice Preferred Bronze PPO? 201 - PPO
Blue Choice Preferred Bronze PPO? 701 - PPO
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
Blue Choice Preferred Gold PPO? 204 - PPO
Blue Choice Preferred Gold PPO? 901 - PPO
Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
Blue Choice Preferred Security PPO? 200 - PPO
Blue Choice Preferred Silver PPO? 203 - PPO
Blue Choice Preferred Silver PPO? 801 - PPO
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO

Cigna Healthcare

Connect Bronze 2000 Indiv Med Deductible - HMO
Connect Bronze 5000 Indiv Med Deductible - Rx Copay - HMO
Connect Bronze CMS Standard - HMO
Connect Gold CMS Standard - Rx Copay - HMO
Connect Silver 3000 Indiv Med Deductible - Rx Copay - HMO
Connect Silver CMS Standard - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Alisha Thomas is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

DME-Other DME (DE000N)
Nebulizer, with compressor (HCPCS:E0570)
1 DME suppliers used 14 Medicare Claims 14 Services Paid

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 60644 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $94.06
Minimum New Patient Price $60.08
Maximum New Patient Price $183.39

Average New Patient Copayment $23.51
Minimum New Patient Copayment $15.02
Maximum New Patient Copayment $45.84

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $105.7
Minimum Established Patient Price $18.97
Maximum Established Patient Price $148.12

Average Established Patient Copayment $26.42
Minimum Established Patient Copayment $4.74
Maximum Established Patient Copayment $37.03

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	6	0	9	0	7	4	6	5	7
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	6	0	9	0	7	8	6	10
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 0 + 9 + 0 + 7 + 8 + 6 + 1 + 0 + 24 = 63
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 63 = 7									7

The NPI number 1609074657 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 20 providers are registered at the same or nearby location.

CHRISTINE SWARTZ MD

Family Medicine

5425 W LAKE ST
CHICAGO, IL
ZIP 60644

About ALISHA THOMAS

Location Map

Specialty - Primary Taxonomy

Family Medicine

Insurance Plans Accepted

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

Eligible to Order or Refer a Home Health Agency (HHA): Yes

Eligible to Order or Refer Power Mobility Devices: Yes