Individual provider Active NPI

Thomas J Harrison, FNP-C

  • Family Nurse Practitioner
  • West Islip, NY
National Provider Identifier
1083642938
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F334847 Issued in NY
Practice address
540 Union Blvd
West Islip, NY 11795-3105
Phone
(631) 669-2555
Fax
(631) 669-5787
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X F334847 NY
Family Nurse Practitioner 363LF0000X F334847 NY Primary

Addresses

Primary practice location

540 Union Blvd
West Islip, NY 11795-3105

Mailing address

PO Box 1609
Port Washington, NY 11050-7609
Phone (631) 669-2555

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
I20070402000460 NY Practitioner - Nurse Practitioner 5890899736 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York at Stony Brook, School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

301 E Main St
Bay Shore, NY 11706-8408
Phone (631) 986-3308

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F334847NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
St. Francis Hospital Current Accepting new patients
North Shore-Lij Medical PC CurrentSince Apr 24, 2015 Accepting new patients
St. Francis Hospital CurrentSince Sep 1, 2014 Accepting new patients
St Catherine of Siena Medical Center Past Accepting new patients
St Francis Hospital United States Catholic Conference Past Accepting new patients
St. Catherine's Bone Density Past Accepting new patients
St Francis Hospital Past Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

300 Community Dr
Plandome, NY 11030

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

540 Union Blvd
West Islip, NY 11795
Phone (631) 669-2555

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

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

Interoperability endpoints

  • Direct secure messaging: thomasharrison@nslijmedgr.allscriptsdirect.net
  • Direct secure messaging: tharrison10050@direct-chsli.net

Organizations & group practices 7

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1083642938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1609",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110507609",
            "telephone_number": "631-669-2555",
            "fax_number": "631-669-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 UNION BLVD",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117953105",
            "telephone_number": "631-669-2555",
            "fax_number": "631-669-5787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "THOMAS",
        "middle_name": "J",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "F334847",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F334847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

Verify at the official NPI Registry.