Individual provider Active NPI

Avinash Thomas, PA

  • Physician Assistant
  • Stamford, CT
National Provider Identifier
1447744594
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
022075 Issued in NY
Practice address
2015 W Main St # 350
Stamford, CT 06902-4536
Phone
(203) 863-4588
NPI assigned
Jun 20, 2018
Last updated
Jun 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 022075 NY Primary

Addresses

Primary practice location

2015 W Main St # 350
Stamford, CT 06902-4536

Mailing address

26008 73Rd Ave FL 1
Glen Oaks, NY 11004-1030
Phone (516) 770-8331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190806001914 NY Practitioner - Physician Assistant 3274860838 Reassigns benefits to 1 organization
I20211004000279 CT Practitioner - Physician Assistant 3274860838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

1244 Storrs Rd
Road
Storrs, CT 06268-2200
Phone (860) 724-2579

2800 Main St
Bridgeport, CT 06606-4201

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
022075NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Oct 25, 2021 Accepting new patients
Montefiore Medical Center CurrentSince Jun 12, 2019 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Oct 25, 2021 Accepting new patients
Montefiore Medical Center CurrentSince Jun 12, 2019 Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

111 E 210th St
Bronx, NY 10467

Interoperability endpoints

  • Direct secure messaging: athomas69742@northwell.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1447744594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26008 73RD AVE FL 1",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041030",
            "telephone_number": "516-770-8331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 W MAIN ST # 350",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069024536",
            "telephone_number": "203-863-4588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "AVINASH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-20",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.