Individual provider Active NPI

Thomas Kysor

  • Physician Assistant
  • Manchester, NH
National Provider Identifier
1033858576
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1260 Elm St
Manchester, NH 03101-1354
Phone
(603) 801-1412
NPI assigned
Jun 2, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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 Primary

Addresses

Primary practice location

1260 Elm St
Manchester, NH 03101-1354

Mailing address

1260 Elm St
Manchester, NH 03101-1305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, ME2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230914000266 NH Practitioner - Physician Assistant 5698139301 Reassigns benefits to 1 organization
I20250903001315 ME Practitioner - Physician Assistant 5698139301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
York HospitalGroup PAC ID 6406766781, 202 clinicians
Intensive Care Consortium IncGroup PAC ID 0244269413, 485 clinicians

Practice addresses (Care Compare)

15 Hospital Dr
York, ME 03909-1011
Phone (207) 363-4321

16 Hospital Dr
York, ME 03909-1011
Phone (207) 351-3715

333 Borthwick Ave
Portsmouth, NH 03801-4198
Phone (603) 436-5110

Hospital & facility affiliations

National Provider Directory

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1033858576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 ELM ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 ELM ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011354",
            "telephone_number": "603-801-1412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYSOR",
        "first_name": "THOMAS",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-02",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.