Individual provider Active NPI

Thomas S. Doty, P.A.

  • Physician Assistant
  • Staten Island, NY
National Provider Identifier
1114983434
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
010661-1 Issued in NY
Practice address
3311 Hylan Blvd
2ND Floor
Staten Island, NY 10306-3688
Phone
(718) 667-7500
Fax
(718) 351-1580
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 010661-1 NY Primary

Addresses

Primary practice location

3311 Hylan Blvd
2ND Floor
Staten Island, NY 10306-3688

Mailing address

1099 Targee St
Administration
Staten Island, NY 10304-4310
Phone (718) 448-3210

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
I20070322000491 NY Practitioner - Physician Assistant 5193742260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
White Plains Physician Services PCGroup PAC ID 3476894445, 386 clinicians

Practice addresses (Care Compare)

185 Kisco Ave
Suite 300
Mount Kisco, NY 10549-1409
Phone (914) 242-2020

Hospital & facility affiliations

  • Burke Rehabilitation Hospital Inpatient rehabilitation facility, White Plains, NY, CCN 333030

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
010661-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
White Plains Physician Services PC CurrentSince Jan 1, 2021 Accepting new patients
Sovereign Medical Group LLC Past Accepting new patients
Gco, LLC Past Accepting new patients

Locations

99 Business Park Dr
Armonk, NY 10504
Phone (914) 219-8515

185 Kisco Ave
Ste 300
Mount Kisco, NY 10549
Phone (914) 242-2020

122 Maple Ave
Fl 8
White Plains, NY 10601
Phone (914) 849-5300

222 Westchester Ave
Ste 101
White Plains, NY 10604
Phone 9149461010324

41 E Post Rd
White Plains, NY 10601
Phone (914) 681-1201

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114983434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 TARGEE ST",
            "address_2": "ADMINISTRATION",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103044310",
            "telephone_number": "718-448-3210",
            "fax_number": "718-442-9085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 HYLAN BLVD",
            "address_2": "2ND FLOOR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063688",
            "telephone_number": "718-667-7500",
            "fax_number": "718-351-1580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOTY",
        "first_name": "THOMAS",
        "middle_name": "S.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010661-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.