Individual provider Active NPI

Derron Thomas

  • Certified Registered Nurse Anesthetist
  • Rockville Centre, NY
National Provider Identifier
1174927156
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
106538 Issued in NY
Practice address
1000 N Village Ave
Rockville Centre, NY 11570-1000
Phone
(516) 705-1000
NPI assigned
Oct 20, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 606175 NY
Certified Registered Nurse Anesthetist 367500000X 106538 NY Primary

Addresses

Primary practice location

1000 N Village Ave
Rockville Centre, NY 11570-1000

Mailing address

1000 N Village Ave
Rockville Centre, NY 11570-1000
Phone (516) 705-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150414001452 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052639598 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
State University of New York Downstate Medical Center, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Cardiovascular Anesthesiologists, P.C.Group PAC ID 5799676623, 135 clinicians
Upstate Anesthesia Services, P.C.Group PAC ID 0840383857, 47 clinicians
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

1000 N Village Ave
Rockville Center, NY 11570-1000
Phone (516) 627-6624

115 Eileen Way
Syosset, NY 11791-5302
Phone (516) 795-3033

530 1St Ave
New York, NY 10016-6402

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-6037

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
606175NYMDRegistered Nurse
106538NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coney Island Medical Practice Plan, P.C. CurrentSince Feb 9, 2015 Accepting new patients
New York University CurrentSince May 17, 2022 Accepting new patients
New York Cardiovascular Anesthesiologists, P.C. CurrentSince May 1, 2025 Accepting new patients
New York University CurrentSince May 17, 2022 Accepting new patients
Jamaica Anesthesiologist, PC CurrentSince Mar 21, 2015 Accepting new patients
Upstate Anesthesia Services, P.C. CurrentSince Aug 5, 2023 Accepting new patients
New York University Current Accepting new patients
Long Island Anesthesia Physicians LLP CurrentSince Jan 6, 2018 Accepting new patients

Locations

451 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 245-3131

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

2201 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 486-6862

259 1st St
Mineola, NY 11501
Phone (516) 576-1820

530 1st Ave
New York, NY 10016
Phone (212) 263-7216

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

1000 N Village Ave
Ste 508
Rockville Ctr, NY 11570
Phone (516) 764-7900

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

115 Eileen Way
Syosset, NY 11791
Phone (516) 622-9797

Organizations & group practices 8

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.

Hospital & facility affiliations 10

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": "1413763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1174927156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N VILLAGE AVE",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115701000",
            "telephone_number": "516-705-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N VILLAGE AVE",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115701000",
            "telephone_number": "516-705-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "DERRON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-20",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "606175",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "106538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.