Individual provider Active NPI

Antoinette D Moore-Thomas, FNP -BC

  • Family Nurse Practitioner
  • Syosset, NY
National Provider Identifier
1104244128
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F346460-01 Issued in NY
Practice address
55 Cold Spring Rd
Syosset, NY 11791-3108
Phone
(866) 389-2727
NPI assigned
Apr 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 603601-1 NY
Family Nurse Practitioner 363LF0000X F346460-01 NY Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 406967 NY

Addresses

Primary practice location

55 Cold Spring Rd
Syosset, NY 11791-3108

Mailing address

55 Cold Spring Rd
Syosset, NY 11791-3108
Phone (866) 389-2727

Other practice location 1

204 Powell Ave
Central Islip, NY 11722-2506
Phone (631) 626-4264

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
I20210126000403 NY Practitioner - Nurse Practitioner 9436563897 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Leslie Marino MD PLLCGroup PAC ID 5092150573, 4 clinicians

Practice addresses (Care Compare)

50 Park Ave
Babylon, NY 11702-1708
Phone (631) 502-7938

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
603601-1NYMDRegistered Nurse
F346460-01NYMDFamily Nurse Practitioner
406967NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Leslie Marino MD PLLC CurrentSince Aug 26, 2025 Accepting new patients
Thomascares LLC Psychiatric/Mental Health CurrentSince Oct 12, 2025 Accepting new patients
Theralympic Speech Therapy PLLC CurrentSince Jan 1, 2022 Accepting new patients
Medical Group of New York, P.C. Family CurrentSince Oct 1, 2020 Accepting new patients
South Lake Chiropractic P.C. CurrentSince Aug 26, 2025 Accepting new patients
County of Suffolk CurrentSince Sep 27, 2023 Accepting new patients

Locations

50 Park Ave
Babylon, NY 11702
Phone (631) 422-4234

107 S Country Rd
Bellport, NY 11713
Phone (631) 286-2222

7960 Metropolitan Ave
Middle Village, NY 11379
Phone (718) 326-4910

622 Hawkins Ave
Ronkonkoma, NY 11779
Phone (631) 240-3579

55 Cold Spring Rd
Syosset, NY 11791
Phone (516) 921-5910

Organizations & group practices 6

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": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1104244128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 COLD SPRING RD",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117913108",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 COLD SPRING RD",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117913108",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 Powell Ave",
            "address_purpose": "LOCATION",
            "city": "Central Islip",
            "state": "NY",
            "postal_code": "117222506",
            "country_code": "US",
            "telephone_number": "631-626-4264",
            "fax_number": "631-532-4242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE-THOMAS",
        "first_name": "ANTOINETTE",
        "middle_name": "D",
        "credential": "FNP -BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-07",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "603601-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F346460-01",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "406967",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

Verify at the official NPI Registry.