Individual provider Active NPI

Sandra Thomas

  • Adult Health Nurse Practitioner
  • East Setauket, NY
National Provider Identifier
1003161183
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F305109-1 Issued in NY
Practice address
235 N Belle Mead Rd
East Setauket, NY 11733-3456
Phone
(631) 724-4664
NPI assigned
Jul 16, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F305109-1 NY Primary

Addresses

Primary practice location

235 N Belle Mead Rd
East Setauket, NY 11733-3456

Mailing address

65 Church LN
Middle Island, NY 11953-1705
Phone (631) 924-1738

Other names 1

  • Sandra Thomas Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190412000906 NY Practitioner - Nurse Practitioner 7911248323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York at Stony Brook, School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Hematology Oncology Associates PCGroup PAC ID 1456243641, 474 clinicians

Practice addresses (Care Compare)

340 Broadhollow Rd
Farmingdale, NY 11735-4807
Phone (631) 751-3000

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F305109-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Hematology Oncology Associates PC CurrentSince Jan 20, 2019 Accepting new patients

Locations

340 Broadhollow Rd
Farmingdale, NY 11735
Phone (516) 931-0041

1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354

49 Route 347
Port Jefferson Station, NY 11776
Phone (631) 751-0000

235 N Belle Mead Rd
Setauket, NY 11733
Phone (631) 450-1200

119 Terry Rd
Smithtown, NY 11787

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: sthomas61124@northwell.direct-ci.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1003161183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 CHURCH LN",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119531705",
            "telephone_number": "631-924-1738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 N BELLE MEAD RD",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333456",
            "telephone_number": "631-724-4664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "SANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-16",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F305109-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "THOMAS",
            "credential": "ANP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.