Active NPI
Thomas Mark Carroll, DDS
- Dentist
- Brewerton, NY
National Provider Identifier
1023043031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3T393
- Practice address
- 9651 Brewerton Rd
Brewerton, NY 13029-0189 - Phone
- (315) 676-7900
- Fax
- (315) 676-7108
- NPI assigned
- Jul 11, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 3T393 | NY | Primary |
Addresses
Primary practice location
9651 Brewerton Rd
Brewerton, NY 13029-0189
Mailing address
PO Box 189
9651 Brewerton Rd
Brewerton, NY 13029-0189
Phone (315) 676-7900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3T393 | NY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tom McCue IV DDS PC | Dentist | Past | Accepting new patients |
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": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023043031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 189",
"address_2": "9651 BREWERTON RD",
"city": "BREWERTON",
"state": "NY",
"postal_code": "130290189",
"telephone_number": "315-676-7900",
"fax_number": "315-676-7108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9651 BREWERTON RD",
"city": "BREWERTON",
"state": "NY",
"postal_code": "130290189",
"telephone_number": "315-676-7900",
"fax_number": "315-676-7108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "THOMAS",
"middle_name": "MARK",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "3T393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brewerton, NY
- Brewerton Family Dentistry
- Brewerton Pharmacy Inc (Brewerton Pharmacy)
- Brewerton Volunteer Fire Department Ambulance Inc (Brewerton Ambulance)
- Brett R Bunker, P.A.
- Jason Vincent Calcara, MS, OTR/L
- Alexia Lynn Cavanaugh, FNP
- Cherice Stebbins NP in Family Health PLLC
- Nicholas Chervinsky, RPH
- Marhenra J Ciccone, M.S., CRC
- Sonya Nicole Cleveland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.