Individual provider Active NPI

Helene M Tomberelli

  • Psychiatry Physician
  • Marcy, NY
National Provider Identifier
1124220710
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
332469 Issued in NY
Practice address
300 Wright Avenue
Marcy, NY 13404
Phone
(315) 736-8271
NPI assigned
Jun 5, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
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
Psychiatry Physician 2084P0800X 332469 NY Primary

Addresses

Primary practice location

300 Wright Avenue
Marcy, NY 13404

Mailing address

9313 State Route 414
Lodi, NY 14860-9641

Other identifiers 1

IdentifierTypeStateIssuer
332469MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
332469NYMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124220710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9313 STATE ROUTE 414",
            "city": "LODI",
            "state": "NY",
            "postal_code": "148609641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WRIGHT AVENUE",
            "city": "MARCY",
            "state": "NY",
            "postal_code": "13404",
            "telephone_number": "315-736-8271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMBERELLI",
        "first_name": "HELENE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "332469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "332469",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marcy, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.