Individual provider Active NPI

Karen Gil-Tommasino, RPA-C

  • Family Medicine Physician
  • Coram, NY
National Provider Identifier
1104040948
Registry record updated Oct 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
007690 Issued in NY
Practice address
3650 Route 112
Coram, NY 11727-4131
Phone
(631) 320-3200
Fax
(631) 880-7603
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 007690 NY Primary

Addresses

Primary practice location

3650 Route 112
Coram, NY 11727-4131

Mailing address

465 Blue Point Rd
Farmingville, NY 11738-1839
Phone (631) 732-5999

Other identifiers 1

IdentifierTypeStateIssuer
007690OtherNYNYS MEDICAL LICENSE NUMBE

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
I20100503000199 NY Practitioner - Physician Assistant 0648308270 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007690NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, P.C Past Accepting new patients

Organizations & group practices 3

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445472000000",
    "number": "1104040948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 BLUE POINT RD",
            "city": "FARMINGVILLE",
            "state": "NY",
            "postal_code": "117381839",
            "telephone_number": "631-732-5999",
            "fax_number": "631-696-1132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 ROUTE 112",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117274131",
            "telephone_number": "631-320-3200",
            "fax_number": "631-880-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIL-TOMMASINO",
        "first_name": "KAREN",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2015-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "007690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS MEDICAL LICENSE NUMBE",
            "identifier": "007690",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coram, NY

Sources for this page

Verify at the official NPI Registry.