Organization Active NPI

Anthony Tomasso, DO PLLC

  • Family Medicine Physician
  • Shirley, NY
National Provider Identifier
1306005699
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
185350 Issued in NY
Legal business name
ANTHONY TOMASSO, DO PLLC
Practice address
2 Coraci Blvd
Ste #4
Shirley, NY 11967-4833
Phone
(631) 281-8670
Fax
(631) 281-8242
NPI assigned
Jun 3, 2008
Last updated
Jun 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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

Authorized official

Name
Dr. Anthony Tomasso, DONPI 1962408708
Title
Physician
Phone
(631) 281-8670

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 Physician 207Q00000X 185350 NY Primary

Addresses

Primary practice location

2 Coraci Blvd
Ste #4
Shirley, NY 11967-4833

Mailing address

2 Coraci Blvd
Ste #4
Shirley, NY 11967-4833
Phone (631) 281-8670

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040719001152 NY Part B Supplier - Clinic/Group Practice 8820077159 Receives reassigned benefits from 1 practitioner
Practice locations: East Patchogue, NY; Shirley, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0160626Anthony Tomasso DO2 Coraci Boulevard Suite 4, Shirley, NY 11967Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

2 Coraci Blvd
Ste 4
Shirley, NY 11967
Phone (631) 281-8670

Practitioners & affiliated clinicians

Practitioners 1

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": "1212451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212451200000",
    "number": "1306005699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CORACI BLVD",
            "address_2": "STE #4",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119674833",
            "telephone_number": "631-281-8670",
            "fax_number": "631-281-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CORACI BLVD",
            "address_2": "STE #4",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119674833",
            "telephone_number": "631-281-8670",
            "fax_number": "631-281-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY TOMASSO, DO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-03",
        "last_updated": "2008-06-03",
        "status": "A",
        "authorized_official_last_name": "TOMASSO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "631-281-8670",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "185350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shirley, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; 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.