Individual provider Active NPI

Thomas V Smallman, MD

  • Orthopaedic Surgery Physician
  • Skaneateles, NY
National Provider Identifier
1174528145
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
216518 Issued in NY
Practice address
3 Chestnut Cir
Skaneateles, NY 13152
Phone
(315) 415-0612
Fax
(315) 554-8185
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 216518-1 NM
Orthopaedic Surgery Physician 207X00000X 216518 NY Primary

Addresses

Primary practice location

3 Chestnut Cir
Skaneateles, NY 13152

Mailing address

3 Chestnut Cir
Skaneateles, NY 13152-1301
Phone (315) 415-0612

Other identifiers 1

IdentifierTypeStateIssuer
01713895MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100108000393 NY Practitioner - Orthopedic Surgery 0446391726 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
216518NYMDOrthopaedic Surgery Physician
216518-1NMMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas V Smallman, MD, PLLC Orthopaedic Surgery CurrentSince Jun 17, 2019 Accepting new patients
Upstate Orthopedics, LLP Orthopaedic Surgery Past Accepting new patients
Murray and Wray Orthopaedic Surgery Past Accepting new patients

Locations

5100 W Taft Rd
Ste 2R
Liverpool, NY 13088
Phone (315) 452-2055

Interoperability endpoints

  • Direct secure messaging: smallmat@hiemail.healtheconnections.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1174528145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 CHESTNUT CIR",
            "city": "SKANEATELES",
            "state": "NY",
            "postal_code": "131521301",
            "telephone_number": "315-415-0612",
            "fax_number": "315-554-8185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CHESTNUT CIR",
            "city": "SKANEATELES",
            "state": "NY",
            "postal_code": "13152",
            "telephone_number": "315-415-0612",
            "fax_number": "315-554-8185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALLMAN",
        "first_name": "THOMAS",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NM",
            "license": "216518-1",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "216518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01713895",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skaneateles, NY

Sources for this page

Verify at the official NPI Registry.