Individual provider Active NPI

Thomas Venditti, RPA-C

  • Physician Assistant
  • Broadalbin, NY
National Provider Identifier
1063418457
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
005837 Issued in NY
Practice address
3768 St Hwy 30
Broadalbin, NY 12025
Phone
(518) 883-3121
Fax
(518) 883-3280
NPI assigned
Jun 22, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 005837 NY Primary

Addresses

Primary practice location

3768 St Hwy 30
Broadalbin, NY 12025

Mailing address

PO Box 923
Broadalbin, NY 12025-0923
Phone (518) 883-3121

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
I20120110000163 NY Practitioner - Physician Assistant 8022284249 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carondelet Regional Medical PCGroup PAC ID 0840554051, 16 clinicians

Practice addresses (Care Compare)

2370 State Hwy 67
Amsterdam, NY 12010-6806
Phone (518) 770-7518

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Marys Healthcare CurrentSince Oct 1, 2021 Accepting new patients
St. Mary's Healthcare CurrentSince Oct 1, 2021 Accepting new patients
St. Mary's Healthcare Past Accepting new patients

Locations

380 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 841-7415

427 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 442-1404

Interoperability endpoints

  • Direct secure messaging: venditti@mayercope.medentdirect.com

Organizations & group practices 4

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 6

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1063418457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 923",
            "city": "BROADALBIN",
            "state": "NY",
            "postal_code": "120250923",
            "telephone_number": "518-883-3121",
            "fax_number": "518-883-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3768 ST HWY 30",
            "city": "BROADALBIN",
            "state": "NY",
            "postal_code": "12025",
            "telephone_number": "518-883-3121",
            "fax_number": "518-883-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENDITTI",
        "first_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "005837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broadalbin, NY

Sources for this page

Verify at the official NPI Registry.