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DR. THOMAS WATSON DOWNES III M.D.
NPI 1689725814
Surgery in Boaz, AL

Active since January 15, 2007PECOS Enrolled
100/100
CMS Quality Rating
2525 US HIGHWAY 431, SUITE 170, BOAZ, AL 35957(256) 593-1611(256) 840-4596 Get Directions Write a Review

NPPES record last updated: February 16, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Thomas Watson Downes Iii M.d. NPPES

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

DR. THOMAS WATSON DOWNES III M.D. (NPI 1689725814) is an individual surgery provider in Boaz, Alabama, licensed in Alabama (15086) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1689725814
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. THOMAS WATSON DOWNES IIICredential: M.D.
Location Address2525 US HIGHWAY 431, SUITE 170Boaz, AL 35957-5934
Mailing Address2525 Us Highway 431, Suite 170Boaz, AL 35957-5934 · (256) 593-1611 · Fax (256) 840-4596
Phone(256) 593-1611
Fax(256) 840-4596
Sole ProprietorNo
Enumeration DateJanuary 15, 2007
Last NPPES UpdateFebruary 16, 2012
✔ NPI 1689725814 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in AL · 15086
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
2525 US HIGHWAY 431, Boaz, AL 35957
Open in Google Maps ↗

Other Identifiers 4

Medicare ID-Type Unspecified000082305AL
Other51082305AL · Blue Cross Blue Shield
Medicare UPINE44350AL
Medicaid000082305AL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Magnolia Health, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Thomas Watson Downes Iii M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Areas of Expertise CMS Part B claims 7

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.

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.
84 services73 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.
51 services51 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.
35 services29 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.
29 services29 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
21 services21 patients
Removal of gallbladder using an endoscope 47562
This procedure, known as endoscopic gallbladder removal, involves a surgeon using a special tool called an endoscope to remove your gallbladder through small incisions. It's typically done to treat gallstones and related complications. It's a less invasive method, often leading to quicker recovery.
13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35957 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
$81.90 typical visit price
range $52.65 – $161.63
Typical copayment $20.47 (range $13.16 – $40.40)
Most-billed visit code 99203
Established Patient
$66.08 typical visit price
range $16.56 – $131.65
Typical copayment $16.52 (range $4.14 – $32.91)
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality100
Improvement Activities40

Reported Quality Measures

Breast Cancer Screening
95%355 patients5/55-star benchmark: 93%
Closing the Referral Loop: Receipt of Specialist Report
90%98 patients5/55-star benchmark: 87%
Colorectal Cancer Screening
91%718 patients5/55-star benchmark: 88%
Controlling High Blood Pressure
61%403 patients3/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
99%1,670 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
90%1,378 patients4/55-star benchmark: 98%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 98% · 232 patients
Patients screened: 99% · 232 patients
96%48 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 12

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

MARSHALL COUNTY PEDIATRICS, PC
Specialist
2525 US HIGHWAY 431, STE 104
BOAZ, AL 35957
Marshall County (256) 571-8969
DR. JENNA CARPENTER D.O.
Internal Medicine (Pulmonary Disease)
2525 US HIGHWAY 431, PULMONARY AND SLEEP ASSOCIATES, SUITE 210
BOAZ, AL 35957
Marshall County (256) 840-4653
MARSHALL SURGICAL CLINIC, PC
Surgery
2525 US HIGHWAY 431, SUITE 170
BOAZ, AL 35957
Marshall County (256) 593-1611
ASHLEY NICOLE COLQUITT CRNP
Nurse Practitioner (Acute Care)
2525 US HIGHWAY 431, SUITE 104
BOAZ, AL 35957
Marshall County (256) 840-4653
DR. GEORGE PHILIP MD.
Internal Medicine (Interventional Cardiology)
2525 US HIGHWAY 431, SUITE 250
BOAZ, AL 35957
Marshall County (256) 539-4080
DR. DOUGLAS WAYNE CLINK M.D.
Surgery
2525 US HIGHWAY 431, SUITE 170
BOAZ, AL 35957
Marshall County (256) 593-1611
MARSHALL MEDICAL CENTER SOUTH BURSON UROLOGY
Urology
2525 US HIGHWAY 431, SUITE 150
BOAZ, AL 35957
Marshall County (256) 840-4855
ANDREANA MEGAN JOHNSON MD
Obstetrics & Gynecology
2525 US HIGHWAY 431, SUITE 200
BOAZ, AL 35957
Marshall County (256) 840-3396

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Thomas Downes's NPI number?

The NPI number for Thomas Downes is 1689725814. It was assigned to this individual provider in the NPPES registry on January 15, 2007.

Where is Thomas Downes located?

Thomas Downes practices at 2525 Us Highway 431 Suite 170, Boaz, AL 35957. The listed phone number is (256) 593-1611.

What is Thomas Downes's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Thomas Downes enrolled in Medicare?

Yes. Thomas Downes is registered in the Medicare PECOS enrollment system.

What insurance does Thomas Downes accept?

Health plans from Ambetter Health, Ambetter from Magnolia Health, Ambetter of Alabama, Ambetter of Tennessee and Blue Cross and Blue Shield of Alabama and 1 other insurer list Thomas Downes as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Thomas Downes was last updated on February 16, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.