Active NPI
Thomas Michael Goldrick, RPA
- Physician Assistant
- Smithtown, NY
National Provider Identifier
1487483020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 032116
- Practice address
- 290 E Main St Ste 200
Smithtown, NY 11787-2916 - Phone
- (631) 361-5302
- NPI assigned
- Jul 31, 2024
- Last updated
- Aug 1, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 032116 | NY | Primary |
Addresses
Primary practice location
290 E Main St Ste 200
Smithtown, NY 11787-2916
Mailing address
25 Dorothy Dr
Syosset, NY 11791-3715
Phone (516) 650-0733
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 032116 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722470400000",
"number": "1487483020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 DOROTHY DR",
"city": "SYOSSET",
"state": "NY",
"postal_code": "117913715",
"telephone_number": "516-650-0733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "290 E MAIN ST STE 200",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117872916",
"telephone_number": "631-361-5302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDRICK",
"first_name": "THOMAS",
"middle_name": "MICHAEL",
"credential": "RPA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-07-31",
"last_updated": "2024-08-01",
"certification_date": "2024-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "032116",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smithtown, NY
- Gold Coast Physical Therapists & Therapy Assistants (Gold Coast Physical Therapy and Sports Training)
- Gold Coast Podiatry, PC
- Avram Gold, M.D.
- Richard Samuel Gold, MD
- Richard Bruce Goldman, D.D.S.
- Jenna Nicole Goldstein, PA-C
- Richard Scott Goldstein, MD
- Tracy-Lynn Patricia Goldstein, LMSW, LCSW
- Vanessa Fonseca Gomes, PHD
- Jose Manuel Gomez
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.