Individual provider Active NPI

Peter A Tomasello Jr., DO

  • Orthopaedic Surgery Physician
  • Jamestown, NY
National Provider Identifier
1174518120
Registry record updated Jul 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
OS7358 Issued in FL
Practice address
207 Foote Ave
Jamestown, NY 14701-7077
Phone
(716) 483-5306
Fax
(716) 483-5307
NPI assigned
Sep 15, 2005
Reactivated
Mar 27, 2006
Last updated
Jul 22, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X OS7358 FL Primary

Addresses

Primary practice location

207 Foote Ave
Jamestown, NY 14701-7077

Mailing address

15 S Main St
Jamestown, NY 14701-6626
Phone (716) 488-1877

Other identifiers 1

IdentifierTypeStateIssuer
253152601MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160601001130 NY Practitioner - Orthopedic Surgery 5496934804 Reassigns benefits to 2 organizations
I20170920003770 TX Practitioner - Orthopedic Surgery 5496934804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Nova Southeastern College of Osteo Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6519 Borden Ave
Maspeth, NY 11378-1630
Phone (718) 690-3966

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Aug 21, 2017 Accepting new patients
Cross Bay Orthopedic Surgery PC Orthopaedic Surgery CurrentSince May 1, 2021 Accepting new patients
Mile Bluff Medical Center Inc CurrentSince Feb 1, 2017 Accepting new patients
Jamestown Area Medical Associates, L.L.P. Orthopaedic Surgery CurrentSince Jun 1, 1997 Accepting new patients
Mile Bluff Medical Center Inc Current Accepting new patients
Great Lakes Physician Practice PC Orthopaedic Surgery CurrentSince May 1, 2016 Accepting new patients
Mile Bluff Medical Center Inc Orthopaedic Surgery CurrentSince Feb 1, 2017 Accepting new patients

Locations

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

15 S Main St
Jamestown, NY 14701
Phone (607) 846-2030

207 Foote Ave
Jamestown, NY 14701
Phone (716) 487-0141

31 Sherman St
Ste 2400
Jamestown, NY 14701
Phone (814) 483-5306

6519 Borden Ave
Maspeth, NY 11378
Phone (212) 355-2008

2 Hot Metal St
Pittsburgh, PA 15203
Phone (412) 235-5300

1040 Division St
Mauston, WI 53948
Phone (608) 847-5000

28 Commerce St
Wisconsin Dells, WI 53965
Phone (608) 254-5888

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469145600000",
    "number": "1174518120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 S MAIN ST",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016626",
            "telephone_number": "716-488-1877",
            "fax_number": "716-488-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 FOOTE AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147017077",
            "telephone_number": "716-483-5306",
            "fax_number": "716-483-5307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMASELLO",
        "first_name": "PETER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2016-07-22",
        "deactivation_date": "2006-03-23",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "OS7358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253152601",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NY

Sources for this page

Verify at the official NPI Registry.