DR. THOMAS CHARLES JR. OCHELTREE (DMD) – Oral and Maxillofacial Pathology Dentistry, NPI 1205892973

DR. THOMAS CHARLES JR. OCHELTREE (DMD) is a healthcare provider. based in Bloomington, Illinois. specializing in ORAL SURGERY, MAXILLOFACIAL SURGERY. They hold the professional credentials DMD. They hold a License No. 019025084 (IL). The NPI Number for DR. THOMAS CHARLES JR. OCHELTREE (DMD) is 1205892973

Main info

Male
27 Years Of Experience
Accepts Medicare Assignment
Name
DR. THOMAS CHARLES JR. OCHELTREE (DMD)
NPI
1205892973
Phone
(309) 663-2526
Address
109 N REGENCY DR
Enumeration Date
21 April 2006
Last Update Date
6 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3096632526
Graduation Year
1999 (27 years ago)
PAC ID
5395740161
Group Practice PAC ID
5597713792
Professional Enrollment ID
I20060929000104
Address ID
IL617013515BL109XXDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness85
Years active:20State licenses:1Digital endpointsOther names

56 ORAL SURGERY in IL

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Provider Addresses for DR. THOMAS CHARLES JR. OCHELTREE (DMD)

  • 109, North Regency Drive, Bloomington, McLean County, Illinois, 61701, United States

    BLOOMINGTON, IL 617013515

    Phone: (309) 663-2526

    Fax: (309) 663-4788

    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)

CMS reports 17 Open Payments records for all available years, with a total value of $451.

Total Amount is formed as General ($451) + Research ($0) + Ownership ($0) = $451.

Last reported payment date: 2024-12-13 • Largest payer in this snapshot: BioHorizons Implant Systems Inc. ($358).

Total Amount

$451

General + Research + Ownership

Payments

17

Total payment records

General Amount

$451

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-13

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2006-09-29

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
I20060929000104IOral SurgeryILTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99202New patient office or other outpatient visit, 15-29 minutes1717$0
View full utilization report →

Insurance plans in this area (ZIP 61701)

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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: 5597713792View full group profile
NameSpecialtyState
Oral Surgery, Maxillofacial SurgeryIL
Oral SurgeryIL
Oral Surgery, Maxillofacial SurgeryIL

Reviews

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Frequently asked questions

Is DR. THOMAS CHARLES JR. OCHELTREE (DMD) listed with a National Provider Identifier?
Yes — DR. THOMAS CHARLES JR. OCHELTREE (DMD) has NPI 1205892973 on file in the registry.
Would DR. THOMAS CHARLES JR. OCHELTREE (DMD) appear as active to a payer?
You can treat DR. THOMAS CHARLES JR. OCHELTREE (DMD) as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for DR. THOMAS CHARLES JR. OCHELTREE (DMD)?
At a glance, DR. THOMAS CHARLES JR. OCHELTREE (DMD) is tied to Oral and Maxillofacial Pathology Dentistry. Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. THOMAS CHARLES JR. OCHELTREE (DMD)?
Travel planning: use Bloomington, Illinois as the reference point for DR. THOMAS CHARLES JR. OCHELTREE (DMD), then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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