Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Thomas Benjamin Bales, PA-C

Individual provider Physician Assistant · NPI 1649766114

Mr. Thomas Benjamin Bales, PA-C is a Physician Assistant in Providence, Rhode Island. Qualified in 2018, 8 years ago. Practices with Grace Kwon Corporation, a 2-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California and Rhode Island.

Years since qualifying
8
Licensed in
CA, RI
In the registry since
2018
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

345 Blackstone Blvd
Providence, RI 02906-4800
Phone: (401) 455-6200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA58355 (CA)
Physician Assistant Taxonomy 363A00000X · Licence PA01031 (RI)

Record details

NPI number1649766114
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 7, 2018
Last updated in NPPESSeptember 25, 2020
Certification dateSeptember 25, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Grace Kwon Corporation — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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