Individual provider Active NPI

Thomas John Lovely, MD

  • Neurological Surgery Physician
  • Latham, NY
National Provider Identifier
1114982105
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
184886 Issued in NY
Practice address
1182 Troy Schenectady Rd Suite 100
St. Peter'S Hospital Spine and Neurosurgery
Latham, NY 12110-1000
Phone
(518) 713-5400
Fax
(518) 713-5401
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 184886 NY
Neurological Surgery Physician 207T00000X 184886 NY Primary

Addresses

Primary practice location

1182 Troy Schenectady Rd Suite 100
St. Peter'S Hospital Spine and Neurosurgery
Latham, NY 12110-1000

Mailing address

PO Box 14890
Albany, NY 12212-4890

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040611000527 NY Practitioner - Neurosurgery 0547243388 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter'S Hospital of the City of Albany CurrentSince Aug 1, 2010 Accepting new patients
St. Peter'S Hospital of the City of Albany CurrentSince Aug 1, 2010 Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

1182 Troy Schenectady Rd
Ste 100
Latham, NY 12110
Phone (518) 269-4690

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1114982105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1182 TROY SCHENECTADY RD SUITE 100",
            "address_2": "ST. PETER'S HOSPITAL SPINE AND NEUROSURGERY",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121101000",
            "telephone_number": "518-713-5400",
            "fax_number": "518-713-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVELY",
        "first_name": "THOMAS",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "184886",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "184886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPH Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1182 Troy Schenectady Rd",
            "address_2": "Suite 100",
            "city": "Latham",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121101000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

Verify at the official NPI Registry.