Individual provider Active NPI

Albert L Tomsic Jr., DMD

  • Endodontics
  • Canonsburg, PA
National Provider Identifier
1376658666
Registry record updated Oct 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DS0257871L Issued in PA
Practice address
167 East Pike Street
Canonsburg, PA 15317
Phone
(724) 745-1666
Fax
(724) 745-5072
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DS0257871L PA Primary

Addresses

Primary practice location

167 East Pike Street
Canonsburg, PA 15317

Mailing address

4725 McKnight Rd Ste 222
Pittsburgh, PA 15237-3414
Phone (412) 366-6990

Other identifiers 2

IdentifierTypeStateIssuer
000025781OtherPADELTA DENTAL
519732OtherPAUNITED CONCORDIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160209001013 PA Order and Referring Only - DentistPractitioner - Dentist 6002110293

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS0257871LPAMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Precision Endodontics, LLC Endodontics Past Accepting new patients

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507593600000",
    "number": "1376658666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4725 MCKNIGHT RD STE 222",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152373414",
            "telephone_number": "412-366-6990",
            "fax_number": "412-366-7577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 EAST PIKE STREET",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "15317",
            "telephone_number": "724-745-1666",
            "fax_number": "724-745-5072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMSIC",
        "first_name": "ALBERT",
        "middle_name": "L",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2017-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "PA",
            "license": "DS0257871L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "000025781",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "519732",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canonsburg, PA

Sources for this page

Verify at the official NPI Registry.