Individual provider Active NPI

Moushumi Shoma Datta-Thomas, MD

  • Obstetrics & Gynecology Physician
  • New York, NY
National Provider Identifier
1063612737
Registry record updated Nov 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
241323 Issued in NY
Practice address
90 Maiden LN
Suite 300
New York, NY 10038-4831
Phone
(646) 290-9560
NPI assigned
Jul 20, 2007
Last updated
Nov 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 241323 NY Primary

Addresses

Primary practice location

90 Maiden LN
Suite 300
New York, NY 10038-4831

Mailing address

90 Maiden LN
Suite 300
New York, NY 10038-4831
Phone (646) 290-9560

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
241323NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Roosevelt Hospital Center Obstetrics & Gynecology Past Accepting new patients
St Lukes Roosevelt Community Care Obstetrics & Gynecology Past Accepting new patients

Networks

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1063612737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 MAIDEN LN",
            "address_2": "SUITE 300",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384831",
            "telephone_number": "646-290-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 MAIDEN LN",
            "address_2": "SUITE 300",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384831",
            "telephone_number": "646-290-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATTA-THOMAS",
        "first_name": "MOUSHUMI",
        "middle_name": "SHOMA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-20",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "241323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.