Individual provider Active NPI

Tomonori Nakagama, MD, MPH

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • New York, NY
National Provider Identifier
1427265032
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
License
256704 Issued in NY
Practice address
424 Madison Ave RM 700
New York, NY 10017-1166
Phone
(212) 204-8567
Fax
(212) 808-5510
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 55771 CT
Sports Medicine (Preventive Medicine) Physician 2083S0010X 256704 NY
Sports Medicine (Preventive Medicine) Physician 2083S0010X 55771 CT
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 256704 NY Primary
Occupational Medicine Physician 2083X0100X 256704 NY
Occupational Medicine Physician 2083X0100X 55771 CT

Addresses

Primary practice location

424 Madison Ave RM 700
New York, NY 10017-1166

Mailing address

424 Madison Ave RM 700
New York, NY 10017-1166
Phone (212) 204-8567

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: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55771CTMDSports Medicine (Preventive Medicine) Physician
256704NYMDSports Medicine (Preventive Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Manhattan Wellness Medical Care, PLLC Past Accepting new patients
Japanese Medical Care, PLLC PastSince Sep 17, 2023 Accepting new patients

Organizations & group practices 2

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": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1427265032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 MADISON AVE RM 700",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100171166",
            "telephone_number": "212-204-8567",
            "fax_number": "212-808-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 MADISON AVE RM 700",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100171166",
            "telephone_number": "212-204-8567",
            "fax_number": "212-808-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAGAMA",
        "first_name": "TOMONORI",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "CT",
            "license": "55771",
            "primary": false
        },
        {
            "code": "2083S0010X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Sports Medicine",
            "state": "NY",
            "license": "256704",
            "primary": false
        },
        {
            "code": "2083S0010X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Sports Medicine",
            "state": "CT",
            "license": "55771",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "NY",
            "license": "256704",
            "primary": true
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "NY",
            "license": "256704",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "CT",
            "license": "55771",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.