Individual provider Active NPI

Justin Makai Tom, DO

  • Psychiatry Physician
National Provider Identifier
1093390148
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2749 Issued in NE
Practice address
PSC 9 Box 737
Apo, AE 09123-0008
Phone
(580) 747-1454
NPI assigned
Mar 10, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2749 NE Primary

Addresses

Primary practice location

PSC 9 Box 737
Apo, AE 09123-0008

Mailing address

4881 Sugar Maple Dr
Wright Patterson Afb, OH 45433-5529
Phone (580) 747-1454

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL n/a

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240321002532 OH Practitioner - Psychiatry 0941609580 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2749NEMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mahajan Therapeutics, LLC CurrentSince Jan 1, 2024 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

6300 N Main St
Dayton, OH 45415
Phone (937) 275-1500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1093390148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "454335529",
            "telephone_number": "580-747-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "MIL",
            "address_1": "PSC 9 BOX 737",
            "city": "APO",
            "state": "AE",
            "postal_code": "091230008",
            "telephone_number": "580-747-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOM",
        "first_name": "JUSTIN",
        "middle_name": "MAKAI",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-10",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NE",
            "license": "2749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "address_1": "PSC 9 Box 737",
            "city": "APO",
            "state": "AE",
            "country_code": "US",
            "postal_code": "091230008",
            "country_name": "United States",
            "address_type": "MIL"
        }
    ],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.