Individual provider Active NPI

Thomas Kodz, PA-C

  • Physician Assistant
  • Danbury, CT
National Provider Identifier
1083707533
Registry record updated Jun 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001516 Issued in CT
Practice address
24 Hospital Ave
Danbury, CT 06810-6099
Phone
(203) 739-7447
Fax
(203) 749-9003
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2019

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 001516 CT Primary

Addresses

Primary practice location

24 Hospital Ave
Danbury, CT 06810-6099

Mailing address

24 Hospital Ave
Danbury, CT 06810-6099
Phone (203) 739-7447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20041210000743 CT Practitioner - Physician Assistant 5496712481 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Afc Physicians of Connecticut, PC CurrentSince Jun 1, 2019 Accepting new patients
Norwalk Hospital Association CurrentSince Mar 1, 2020 Accepting new patients
Afc Physicians of Connecticut, PC CurrentSince Jun 1, 2019 Accepting new patients
Danbury Hospital CurrentSince Oct 1, 2014 Accepting new patients
Danbury Hospital CurrentSince Oct 1, 2014 Accepting new patients
Norwalk Hospital Association CurrentSince Mar 1, 2020 Accepting new patients
CT Emergency Medicine Specialists, LLC Past Accepting new patients

Locations

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

20 Germantown Rd
Danbury, CT 06810
Phone (203) 739-4820

2 Main St
Danbury, CT 06810
Phone (203) 826-2140

21 Elm St
New Milford, CT 06776
Phone (860) 210-5000

520 West Ave
Norwalk, CT 06850
Phone (203) 852-2417

Interoperability endpoints

  • Direct secure messaging: tkodz@direct.wtbyhosp.org

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560643200000",
    "number": "1083707533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 HOSPITAL AVE",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106099",
            "telephone_number": "203-739-7447",
            "fax_number": "203-749-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 HOSPITAL AVE",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106099",
            "telephone_number": "203-739-7447",
            "fax_number": "203-749-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODZ",
        "first_name": "THOMAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2019-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "001516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.