Active NPI
Thomas Crowley Miglietta, PA
- Physician Assistant
- Wakefield, RI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA01444
- Practice address
- 100 Kenyon Ave
Wakefield, RI 02879-4216 - Phone
- (401) 782-8000
- NPI assigned
- Jul 10, 2018
- Last updated
- Oct 2, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | PA01444 | RI | Primary |
Addresses
Primary practice location
100 Kenyon Ave
Wakefield, RI 02879-4216
Mailing address
2 Maynard St
Potsdam, NY 13676-1129
Phone (203) 470-6446
Other practice location 1
50 LeRoy St
Potsdam, NY 13676-1799
Phone (315) 265-3300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457847790 | Medicaid | RI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022327 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Canton-Potsdam Hospital | Current | Accepting new patients | |
| Canton-Potsdam Hospital | Current | Accepting new patients | |
| Massena Hospital Inc | Current | Accepting new patients |
Locations
1 Hospital Dr
Massena, NY 13662
Phone (315) 764-1711
201 Market St
Ste E
Potsdam, NY 13676
Phone (315) 274-9102
50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034
Organizations & group practices 4
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.
-
- General Acute Care Hospital
- Potsdam, NY
- NPI 1568548782
-
- Critical Access Hospital
- Massena, NY
- NPI 1972604460
-
- Emergency Medicine Physician
- Wakefield, RI
- NPI 1427381052
-
- Medicare Defined Swing Bed Hospital Unit
- Potsdam, NY
- NPI 1114104445
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696204800000",
"number": "1457847790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 MAYNARD ST",
"city": "POTSDAM",
"state": "NY",
"postal_code": "136761129",
"telephone_number": "203-470-6446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 KENYON AVE",
"city": "WAKEFIELD",
"state": "RI",
"postal_code": "028794216",
"telephone_number": "401-782-8000"
}
],
"practiceLocations": [
{
"address_1": "50 LeRoy St",
"address_purpose": "LOCATION",
"city": "Potsdam",
"state": "NY",
"postal_code": "136761799",
"country_code": "US",
"telephone_number": "315-265-3300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MIGLIETTA",
"first_name": "THOMAS",
"middle_name": "CROWLEY",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-10",
"last_updated": "2023-10-02",
"certification_date": "2022-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "RI",
"license": "PA01444",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1457847790",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wakefield, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.