NPIMap

Individual provider Active NPI

Thomas Edward Degrave, D.O.

  • Family Medicine Physician
  • Orchard Park, NY
National Provider Identifier
1134187537
Registry record updated Jan 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
173319 Issued in NY
Practice address
3670 S Benzing Rd
Orchard Park, NY 14127-1705
Phone
(716) 662-5357
Fax
(716) 662-2774
NPI assigned
May 3, 2006
Last updated
Jan 7, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2016

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 173319 NY Primary

Addresses

Primary practice location

3670 S Benzing Rd
Orchard Park, NY 14127-1705

Mailing address

10271 Darien Rd
Holland, NY 14080-9628

Other identifiers 1

IdentifierTypeStateIssuer
01789519MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051012000836 NY Practitioner - Family Practice 4082639646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orchard Park Family Practice, PCGroup PAC ID 7517937261, 14 clinicians

Practice addresses (Care Compare)

3670 S Benzing Rd
Suite a
Orchard Park, NY 14127-1741
Phone (716) 662-5357

5007 Transit Rd
Depew, NY 14043-4699
Phone (716) 662-5357

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
173319NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orchard Park Family Practice, PC Family Medicine CurrentSince Jun 2, 2010 Accepting new patients
Mindful Living Center Ny LLC PastSince Oct 13, 2021 Accepting new patients
Geriatric Associates, LLP Past Accepting new patients
Thomas E. Degrave, DO,LLC Family Medicine PastSince Jan 16, 2002 Accepting new patients

Locations

3670 S Benzing Rd
Ste A
Orchard Park, NY 14127
Phone (716) 662-5357

Interoperability endpoints

  • Direct secure messaging: drtomdegrave@opfp.medentdirect.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452124800000",
    "number": "1134187537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10271 DARIEN RD",
            "city": "HOLLAND",
            "state": "NY",
            "postal_code": "140809628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3670 S BENZING RD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271705",
            "telephone_number": "716-662-5357",
            "fax_number": "716-662-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGRAVE",
        "first_name": "THOMAS",
        "middle_name": "EDWARD",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2016-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "173319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01789519",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.