NPIMap

Organization Active NPI

Paul a. Tomcykoski DO PC

  • Pediatrics Physician
  • Jessup, PA
National Provider Identifier
1205004207
Registry record updated Feb 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OS009027L Issued in PA
Legal business name
PAUL A. TOMCYKOSKI DO PC
Practice address
1355 Robert Mellow Dr
Jessup, PA 18434
Phone
(570) 383-5453
Fax
(570) 489-4583
NPI assigned
Feb 13, 2008
Last updated
Feb 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2008

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

Authorized official

Name
Paul A Tomcykoski, DO
Title
Physician
Phone
(570) 383-5453

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X OS009027L PA Primary

Addresses

Primary practice location

1355 Robert Mellow Dr
Jessup, PA 18434

Mailing address

1355 Robert Mellow Dr
Jessup, PA 18434
Phone (570) 383-5453

Other identifiers 1

IdentifierTypeStateIssuer
0017888900002MedicaidPA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202860800000",
    "number": "1205004207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 ROBERT MELLOW DR",
            "city": "JESSUP",
            "state": "PA",
            "postal_code": "18434",
            "telephone_number": "570-383-5453",
            "fax_number": "570-489-4583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 ROBERT MELLOW DR",
            "city": "JESSUP",
            "state": "PA",
            "postal_code": "18434",
            "telephone_number": "570-383-5453",
            "fax_number": "570-489-4583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL A. TOMCYKOSKI DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-13",
        "last_updated": "2008-02-13",
        "status": "A",
        "authorized_official_last_name": "TOMCYKOSKI",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "570-383-5453",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OS009027L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017888900002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jessup, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.