Individual provider Active NPI

Bindhu Kanjiravilayil Thomas, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Lyons, NJ
National Provider Identifier
1477732691
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
246044 Issued in NY
Practice address
151 Knollcroft Rd BLDG 135
Lyons, NJ 07939-5001
Phone
(908) 647-0180
Fax
(908) 604-5206
NPI assigned
Oct 24, 2007
Last updated
Jan 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 246044 NY Primary

Addresses

Primary practice location

151 Knollcroft Rd BLDG 135
Lyons, NJ 07939-5001

Mailing address

151 Knollcroft Rd BLDG 135
Lyons, NJ 07939-5001
Phone (908) 647-0180

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
I20081018000009 NY Practitioner - Geriatric MedicinePractitioner - Family PracticePractitioner - Hospice/Palliative Care 1052479169 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
246044NYMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Sep 1, 2008 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jan 1, 2019 Accepting new patients
Trustees of Columbia University in the City of New York Current Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Oct 1, 2014 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Oct 1, 2014 Accepting new patients

Locations

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

5141 Broadway
New York, NY 10034
Phone (212) 932-4000

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

630 W 168th St
#4
New York, NY 10032
Phone (212) 305-6387

Networks

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

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1477732691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 KNOLLCROFT RD BLDG 135",
            "city": "LYONS",
            "state": "NJ",
            "postal_code": "079395001",
            "telephone_number": "908-647-0180",
            "fax_number": "908-604-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 KNOLLCROFT RD BLDG 135",
            "city": "LYONS",
            "state": "NJ",
            "postal_code": "079395001",
            "telephone_number": "908-647-0180",
            "fax_number": "908-604-5206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "BINDHU",
        "middle_name": "KANJIRAVILAYIL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-24",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "246044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyons, NJ

Sources for this page

Verify at the official NPI Registry.