Individual provider Active NPI

William Tomback, D.P.M.

  • Podiatrist
  • Somers, NY
National Provider Identifier
1417955642
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N002882 Issued in NY
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, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
00403434MedicaidNY

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
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002882NYMDMental Health Counselor
N002882NYMDPodiatrist

Interoperability endpoints

  • Direct secure messaging: william.tomback@direct.hvhc.org
  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.