Individual provider Active NPI

Shannon A Tomita, MD

  • Gynecologic Oncology Physician
  • Morristown, NJ
National Provider Identifier
1407112246
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
25MA11032600 Issued in NJ
Practice address
100 Madison Ave
Morristown, NJ 07960-6136
Phone
(973) 971-5900
Fax
(973) 290-7257
NPI assigned
Apr 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X 25MA11032600 NJ Primary

Addresses

Primary practice location

100 Madison Ave
Morristown, NJ 07960-6136

Mailing address

PO Box 416457
Boston, MA 02241-6457
Phone (844) 362-1735

Other practice location 1

1000 10th Ave
New York, NY 10019-1147
Phone (212) 523-4000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210729000011 NJ Practitioner - Gynecological Oncology 5991098105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gynecological Oncology
Education
State University of New York Downstate Medical Center, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596

33 Overlook Rd
Suite 207
Summit, NJ 07901-3562
Phone (908) 598-6517

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus21

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group CurrentSince Aug 2, 2021 Accepting new patients

Locations

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

100 Madison Ave
Fl 2
Morristown, NJ 07960
Phone (973) 538-5210

465 South St
Ste 103
Morristown, NJ 07960
Phone (973) 971-7130

Interoperability endpoints

  • Direct secure messaging: stomita415570@direct.ahsys.org

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.

Hospital & facility affiliations 3

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": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1407112246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457",
            "telephone_number": "844-362-1735",
            "fax_number": "973-290-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MADISON AVE",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079606136",
            "telephone_number": "973-971-5900",
            "fax_number": "973-290-7257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 10th Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100191147",
            "country_code": "US",
            "telephone_number": "212-523-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOMITA",
        "first_name": "SHANNON",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-05",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "NJ",
            "license": "25MA11032600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, NJ

Sources for this page

Verify at the official NPI Registry.