Active NPI
William Tomback, D.P.M.
- Podiatrist
- Somers, NY
National Provider Identifier
1417955642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- N002882
- Practice address
- 1 Primrose Drive
Somers, NY 10589-0390 - Phone
- (914) 232-1803
- Fax
- (914) 232-5538
- NPI assigned
- Jul 12, 2005
- Last updated
- Jan 7, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | N002882 | NY | Primary |
Addresses
Primary practice location
1 Primrose Drive
Somers, NY 10589-0390
Mailing address
PO Box 390
1 Primrose Dr
Somers, NY 10589-0390
Phone (914) 232-1803
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00403434 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002882 | NY | MD | Mental Health Counselor |
| N002882 | NY | MD | Podiatrist |
Interoperability endpoints
- william.tomback@direct.hvhc.org
- wit9033@direct.weillcornell.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Durable Medical Equipment & Medical Supplies
- Somers, NY
- NPI 1407031552
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357516800000",
"number": "1417955642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 390",
"address_2": "1 PRIMROSE DR",
"city": "SOMERS",
"state": "NY",
"postal_code": "105890390",
"telephone_number": "914-232-1803",
"fax_number": "914-232-5538"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PRIMROSE DRIVE",
"city": "SOMERS",
"state": "NY",
"postal_code": "105890390",
"telephone_number": "914-232-1803",
"fax_number": "914-232-5538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOMBACK",
"first_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-12",
"last_updated": "2013-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NY",
"license": "N002882",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00403434",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Somers, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.