ROBERT M. THEAL (MD) – Family Medicine Physician, NPI 1003987991

ROBERT M. THEAL (MD) is a healthcare provider. based in Fontana, California. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. G55100 (CA). The NPI Number for ROBERT M. THEAL (MD) is 1003987991

Main info

Male
42 Years Of Experience
Accepts Medicare Assignment
Name
ROBERT M. THEAL (MD)
NPI
1003987991
Phone
(909) 427-3910
Address
9961 SIERRA AVE
Enumeration Date
13 November 2006
Last Update Date
1 December 2021

Doctor Profile

Medical School Name
UNIVERSITY OF CALIFORNIA, DAVIS SCHOOL OF MEDICINE
Secondary Phone
9094275000
Graduation Year
1984 (42 years ago)
PAC ID
0840208690
Group Practice PAC ID
6002729175
Professional Enrollment ID
I20060405000252
Address ID
CA923356720FO9961XAVEX300

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

13,194 FAMILY PRACTICE in CA

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Provider Addresses for ROBERT M. THEAL (MD)

  • Kaiser Permanente Fontana Medical Center, 9961, Sierra Avenue, Fontana, San Bernardino County, California, 92335, United States

    FONTANA, CA 923356720

    Phone: (909) 427-3910

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-04-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060405000252IFamily PracticeCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92335)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002729175View full group profile
NameSpecialtyState
U R O L O G YOH
Nurse PractitionerCA
Internal MedicineCA
Internal MedicineCA
Physician AssistantCA
N E U R O L O G YCA
Internal MedicineCA
O B S T E T R I C S/ G Y N E C O L O G YCA
Family Practice, Sports MedicineCA
Internal MedicineNY

Reviews

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Frequently asked questions

Does ROBERT M. THEAL (MD) have a public NPI I can cite?
Public records show ROBERT M. THEAL (MD) under NPI 1003987991.
Is ROBERT M. THEAL (MD)'s NPI status active today?
Active status means ROBERT M. THEAL (MD)'s NPI record is not deactivated in the public file.
What does the directory say ROBERT M. THEAL (MD) does?
Insurance directories may phrase it differently, but here ROBERT M. THEAL (MD) maps to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is ROBERT M. THEAL (MD) tied to Fontana, California?
If you are local to Fontana, California, ROBERT M. THEAL (MD) may be relevant to your search.
Why is information missing for ROBERT M. THEAL (MD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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