Organization Active NPI

Michael Tom MD PLLC

  • Psychiatry Physician
  • Brooklyn, NY
National Provider Identifier
1245127570
Registry record updated Oct 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MICHAEL TOM MD PLLC
Practice address
55 Washington St Ste 312B
Brooklyn, NY 11201-1179
Phone
(718) 218-5127
Fax
(718) 957-8734
NPI assigned
Jun 19, 2025
Last updated
Oct 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2025

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

Authorized official

Name
Dr. Michael Ryan Tom, MDNPI 1639706492
Title
Owner
Phone
(718) 218-5127

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
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

55 Washington St Ste 312B
Brooklyn, NY 11201-1179

Mailing address

418 Broadway Ste N
Albany, NY 12207-2922

Other practice location 1

26 Court St
Brooklyn, NY 11242-0103
Phone (718) 218-5127

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251029000125 NY Part B Supplier - Clinic/Group Practice 0941799167 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

55 Washington St
Ste 312B
Brooklyn, NY 11201
Phone (646) 321-5549

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1750291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760140800000",
    "number": "1245127570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 BROADWAY STE N",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122072922",
            "fax_number": "718-957-8734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WASHINGTON ST STE 312B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112011179",
            "telephone_number": "718-218-5127",
            "fax_number": "718-957-8734"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26 Court St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112420103",
            "country_code": "US",
            "telephone_number": "718-218-5127",
            "fax_number": "718-957-8734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MICHAEL TOM MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-19",
        "last_updated": "2025-10-11",
        "certification_date": "2025-10-11",
        "status": "A",
        "authorized_official_last_name": "TOM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-218-5127",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2025; 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.