Individual provider Active NPI

Savanna Thor, D.O.

  • Gastroenterology Physician
  • Brooklyn, NY
National Provider Identifier
1457672529
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
280325 Issued in NY
Practice address
450 Clarkson Ave # Msc1196
Brooklyn, NY 11203-2012
Phone
(718) 270-4772
NPI assigned
Jun 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OTO13136 PA
Student in an Organized Health Care Education/Training Program 390200000X OT013136 PA
Gastroenterology Physician 207RG0100X 280325 NY Primary

Addresses

Primary practice location

450 Clarkson Ave # Msc1196
Brooklyn, NY 11203-2012

Mailing address

450 Clarkson Ave # Msc1196
Brooklyn, NY 11203-2012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151014001478 NY Practitioner - GastroenterologyPractitioner - Internal Medicine 2163731191 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (718) 826-4959

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy17
Upper gastrointestinal (GI) endoscopy for acid reflux23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OTO13136PAMDInternal Medicine Physician
OT013136PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians of Brooklyn, Inc. Current Accepting new patients
University Physicians of Brooklyn, Inc. CurrentSince Aug 14, 2015 Accepting new patients
University Physicians of Brooklyn, Inc. Internal Medicine CurrentSince Aug 14, 2015 Accepting new patients
Be Well Primary Health Care Center, LLC CurrentSince Jun 3, 2024 Accepting new patients
University Physicians of Brooklyn, Inc Past Accepting new patients

Locations

450 Clarkson Ave
#1196
Brooklyn, NY 11203
Phone (718) 270-1835

450 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 270-1603

450 Clarkson Ave
#80
Brooklyn, NY 11203
Phone (718) 613-8481

3007 Farragut Rd
Brooklyn, NY 11210
Phone (347) 915-1177

450 Clarkson Ave
Ste A
Brooklyn, NY 11203
Phone (718) 270-1432

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: savannathor@sunydmc.allscriptsdirect.net
  • Direct secure messaging: sthor1056632@nychhc.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 and National Provider Directory roles.

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": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1457672529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE # MSC1196",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE # MSC1196",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-270-4772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOR",
        "first_name": "SAVANNA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-11",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OTO13136",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "OT013136",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "280325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.