Sobha Panicker-Thomas

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F307945 Issued in NY

Practice address

475 Seaview Ave
Staten Island University Hospital
Staten Island, NY 10305-3436

Phone

(718) 226-9000

NPI assigned

Oct 3, 2016

Last updated

Oct 3, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Sobha Koshy Panicker Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1134678022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVENUE",
            "address_2": "STATEN ISLAND UNIVERSITY HOSPITAL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10305",
            "telephone_number": "718-226-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "address_2": "STATEN ISLAND UNIVERSITY HOSPITAL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-226-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANICKER-THOMAS",
        "first_name": "SOBHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-03",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F307945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SOBHA",
            "last_name": "PANICKER",
            "middle_name": "KOSHY",
            "credential": "NURSE PRACTITIONER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Viveki Pandya, PT
• Philip D Pane, PA-C
• Devin Panepinto
• Jamie Panepinto
• Rose Paniccioli
• Aneena Panicker
• Annamma Panicker
• Dolamma John Panicker I
• Juby John Panicker, PHARMD
• Rithu Sudha Panicker I

• Adult Health Nurse Practitioner in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.