Individual provider Active NPI

Joseph Thomas, MD

  • Pediatrics Physician
  • Centereach, NY
National Provider Identifier
1073505012
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
113843 Issued in NY
Practice address
1344 Middle Country Rd
Centereach, NY 11720-3583
Phone
(631) 698-4932
Fax
(631) 698-2453
NPI assigned
Aug 16, 2005
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
Pediatrics Physician 208000000X 113843 NY Primary

Addresses

Primary practice location

1344 Middle Country Rd
Centereach, NY 11720-3583

Mailing address

1344 Middle Country Rd
Centereach, NY 11720-3583
Phone (631) 698-4932

Other identifiers 1

IdentifierTypeStateIssuer
00378845MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220415000844 NY Practitioner - Pediatric Medicine 7012303274

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
113843NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Kisco Medical Group 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1073505012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1344 MIDDLE COUNTRY RD",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117203583",
            "telephone_number": "631-698-4932",
            "fax_number": "631-698-2453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1344 MIDDLE COUNTRY RD",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117203583",
            "telephone_number": "631-698-4932",
            "fax_number": "631-698-2453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "113843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00378845",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centereach, NY

Sources for this page

Verify at the official NPI Registry.