NPIMap

Individual provider Active NPI

Thomas Isenovski, DO

  • Emergency Medicine Physician
  • Fort Benning, GA
National Provider Identifier
1326149535
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
055602 Issued in GA
Practice address
7950 Martin Loop
Fort Benning, GA 31905-5647
Phone
(706) 544-3612
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 055602 GA Primary

Addresses

Primary practice location

7950 Martin Loop
Fort Benning, GA 31905-5647

Mailing address

39 Oak St
Saratoga Springs, NY 12866-4013
Phone (706) 405-6779

Other identifiers 1

IdentifierTypeStateIssuer
203563559BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110405001023 NY Practitioner - Emergency Medicine 9537147517 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gloversville Emergency Medicine Services PCGroup PAC ID 7517107881, 15 clinicians

Practice addresses (Care Compare)

99 E State St
Gloversville, NY 12078-1203
Phone (518) 773-5780

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.41 of 100Reported as group
Quality
78.6
Improvement activities
40
Cost
79.62

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
055602GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saratoga Hospital Current Accepting new patients
Saratoga Hospital CurrentSince Jul 7, 2020 Accepting new patients
Saratoga Hospital CurrentSince Jul 7, 2020 Accepting new patients
Emergency Care Services of New York, P.C. Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine Past Accepting new patients
Mayer and Cope Family Practice LLP PastSince Jul 1, 1990 Accepting new patients
Manning Emergency Medical Associates PLLC Emergency Medicine Past Accepting new patients

Locations

321 Genesee St
Oneida, NY 13421
Phone (315) 361-2020

211 Church St
Saratoga Springs, NY 12866
Phone (518) 583-8461

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

Organizations & group practices 9

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1326149535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 OAK ST",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128664013",
            "telephone_number": "706-405-6779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7950 MARTIN LOOP",
            "city": "FORT BENNING",
            "state": "GA",
            "postal_code": "319055647",
            "telephone_number": "706-544-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISENOVSKI",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2013-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "055602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203563559B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Benning, GA

Sources for this page

Verify at the official NPI Registry.