Individual provider Active NPI

Daniel Victor Tomasulo, P.A.

  • Physician Assistant
  • Orchard Park, NY
National Provider Identifier
1023069101
Registry record updated Mar 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
008440 Issued in NY
Practice address
3075 Southwestern Blvd
Suite 102
Orchard Park, NY 14127-1236
Phone
(716) 675-0616
Fax
(716) 675-7101
NPI assigned
May 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 008440 NY Primary

Addresses

Primary practice location

3075 Southwestern Blvd
Suite 102
Orchard Park, NY 14127-1236

Mailing address

3075 Southwestern Blvd
Suite 102
Orchard Park, NY 14127-1236
Phone (716) 675-0616

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
I20090612000531 NY Practitioner - Physician Assistant 9739239732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western New York Ear, Nose and Throat, P.C.Group PAC ID 5193762235, 9 clinicians

Practice addresses (Care Compare)

3670 S Benzing Rd
Suite C
Orchard Park, NY 14127-1741
Phone (716) 675-5711

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
8440NYMDSpecialist
008440NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rpci Oncology PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dtomasulo@wnyent.medentdirect.com

Organizations & group practices 2

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299024000000",
    "number": "1023069101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 SOUTHWESTERN BLVD",
            "address_2": "SUITE 102",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271236",
            "telephone_number": "716-675-0616",
            "fax_number": "716-675-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 SOUTHWESTERN BLVD",
            "address_2": "SUITE 102",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271236",
            "telephone_number": "716-675-0616",
            "fax_number": "716-675-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMASULO",
        "first_name": "DANIEL",
        "middle_name": "VICTOR",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2011-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.