Individual provider Active NPI

Thomas Joseph Ekkers, M.D.

  • Gastroenterology Physician
  • Huntington, NY
National Provider Identifier
1457562795
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
096754 Issued in NY
Practice address
27 Camel Hollow Rd
Huntington, NY 11743-1604
Phone
(631) 423-0830
NPI assigned
May 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 096754 NY Primary

Addresses

Primary practice location

27 Camel Hollow Rd
Huntington, NY 11743-1604

Mailing address

27 Camel Hollow Rd
Huntington, NY 11743-1604
Phone (631) 423-0830

Other identifiers 1

IdentifierTypeStateIssuer
00407483MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
096745NYMDClinical Social Worker
096754NYMDGastroenterology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457562795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 CAMEL HOLLOW RD",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117431604",
            "telephone_number": "631-423-0830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 CAMEL HOLLOW RD",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117431604",
            "telephone_number": "631-423-0830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKKERS",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "096754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00407483",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.