Individual provider Active NPI

Nicole Renee Thomas, FNP-BC

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1376412908
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
356227 Issued in NY
Practice address
170 E 77TH St
New York, NY 10075-1912
Phone
(212) 369-9200
NPI assigned
Nov 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 356227 NY Primary

Addresses

Primary practice location

170 E 77TH St
New York, NY 10075-1912

Mailing address

170 E 77TH St
New York, NY 10075-1912
Phone (212) 369-9200

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
I20260327002484 NY Practitioner - Nurse Practitioner 4981189917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Howard John Simon MD PCGroup PAC ID 1658602263, 36 clinicians

Practice addresses (Care Compare)

170 E 77TH St Lower Level
Simonmed Imaging Carnegie Hill
New York, NY 10075-1912
Phone (212) 369-9200

561 10TH Ave
Apt 33J
New York, NY 10036-3057
Phone (480) 306-6949

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
356227NYMDFamily Nurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1762128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1376412908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 E 77TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751912",
            "telephone_number": "212-369-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 E 77TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751912",
            "telephone_number": "212-369-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "NICOLE",
        "middle_name": "RENEE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-03",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "356227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.