Individual provider Active NPI

Thomas Christopher Arnold, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1083123707
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA062254 Issued in PA
Practice address
3400 Spruce Street
Ground Silverstein BLDG
Philadelphia, PA 19104-4206
Phone
(215) 662-6698
Fax
(215) 662-3953
NPI assigned
Sep 26, 2017
Last updated
Dec 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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 MA062254 PA Primary

Addresses

Primary practice location

3400 Spruce Street
Ground Silverstein BLDG
Philadelphia, PA 19104-4206

Mailing address

3400 Spruce Street
Ground Silverstein BLDG
Philadelphia, PA 19104-4206
Phone (215) 662-6698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 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
I20210621000884 PA Practitioner - Physician Assistant 1759647712 Reassigns benefits to 1 organization
I20240412001081 NY Practitioner - Physician Assistant 1759647712 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
026376NYMDOccupational Therapist
MA062254PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Jun 21, 2021 Accepting new patients
The Memorial Hospital of William F. and Gertrude F. Jones, Inc. CurrentSince Mar 18, 2024 Accepting new patients
University of Penn-Medical Group CurrentSince Jun 21, 2021 Accepting new patients

Locations

73 Buffalo St
Canandaigua, NY 14424

73 Buffalo St
Ste 100
Canandaigua, NY 14424

191 N Main St
Wellsville, NY 14895
Phone (585) 593-1100

Organizations & group practices 5

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": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1083123707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "address_2": "GROUND SILVERSTEIN BLDG",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-6698",
            "fax_number": "215-662-3953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "address_2": "GROUND SILVERSTEIN BLDG",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-6698",
            "fax_number": "215-662-3953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "THOMAS",
        "middle_name": "CHRISTOPHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-26",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA062254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.