Individual provider Active NPI

Owen Richard Thompson

  • Physician Assistant
  • Orchard Park, NY
National Provider Identifier
1235866740
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
028448 Issued in NY
Practice address
5959 Big Tree Rd Ste 108
Orchard Park, NY 14127-2291
Phone
(716) 204-3200
Fax
(716) 204-4337
NPI assigned
Aug 4, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 028448 NY Primary

Addresses

Primary practice location

5959 Big Tree Rd Ste 108
Orchard Park, NY 14127-2291

Mailing address

4225 Genesee St Ste 400
Cheektowaga, NY 14225-1994
Phone (716) 204-3200

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220831001355 NY Practitioner - Physician Assistant 9032593637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Orthopaedic Services Inc.Group PAC ID 7810983004, 115 clinicians

Practice addresses (Care Compare)

160 Farber Hall
Buffalo, NY 14214-8001
Phone (716) 829-2070

5959 Big Tree Rd
Orchard Park, NY 14127-2210
Phone (716) 204-3200

Hospital & facility affiliations

  • Brooks-TLC Hospital System, Inc Hospital, Dunkirk, NY, CCN 330229

Merit-based Incentive Payment System (MIPS)

Final score
88.69 of 100Reported as group
Quality
77.6
Promoting interoperability
100
Improvement activities
40
Cost
81.28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
028448NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
University Orthopaedic Services, Inc CurrentSince Aug 2, 2022 Accepting new patients
University Orthopaedic Services Inc. CurrentSince Aug 2, 2022 Accepting new patients

Locations

160 Farber Hall
Buffalo, NY 14214
Phone (716) 829-2070

4225 Genesee St
Ste 400
Cheektowaga, NY 14225
Phone (716) 906-5905

5959 Big Tree Rd
Ste 108
Orchard Park, NY 14127
Phone (716) 810-7997

Organizations & group practices 2

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 4

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": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1235866740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 GENESEE ST STE 400",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142251994",
            "telephone_number": "716-204-3200",
            "fax_number": "716-204-4337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 BIG TREE RD STE 108",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272291",
            "telephone_number": "716-204-3200",
            "fax_number": "716-204-4337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "OWEN",
        "middle_name": "RICHARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-04",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "028448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.