Organization Active NPI

Thomas G. O'Brien II, Ms,DO,PC

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1205050671
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
210513 Issued in NY
Legal business name
THOMAS G. O'BRIEN II, MS,DO,PC
Practice address
244 Madison Ave
Suite 3G
New York, NY 10016-2817
Phone
(516) 330-4173
NPI assigned
Apr 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Thomas Gerald O'Brien II, D.O.NPI 1063434298
Title
Officer
Phone
(516) 330-4173

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 210513 NY Primary

Addresses

Primary practice location

244 Madison Ave
Suite 3G
New York, NY 10016-2817

Mailing address

244 Madison Ave
Suite 3G
New York, NY 10016-2817
Phone (516) 330-4173

Other identifiers 1

IdentifierTypeStateIssuer
210513OtherNYLICENSE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250326003455 NY Part B Supplier - Clinic/Group Practice 5698298040 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY; Jackson Heights, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205050671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 MADISON AVE",
            "address_2": "SUITE 3G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100162817",
            "telephone_number": "516-330-4173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 MADISON AVE",
            "address_2": "SUITE 3G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100162817",
            "telephone_number": "516-330-4173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS G. O'BRIEN II, MS,DO,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "O'BRIEN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "GERALD",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "516-330-4173",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "210513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "210513",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.