Individual provider Active NPI

Siby Thomas, FNP

  • Family Nurse Practitioner
  • Garnerville, NY
National Provider Identifier
1497140867
Registry record updated Apr 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F339224-1 Issued in NY
Practice address
2 Suffern LN
Garnerville, NY 10923-1311
Phone
(845) 429-1800
NPI assigned
Apr 2, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F339224-1 NY Primary

Addresses

Primary practice location

2 Suffern LN
Garnerville, NY 10923-1311

Mailing address

2 Suffern LN
Garnerville, NY 10923-1311
Phone (845) 825-6539

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191126000609 TX Practitioner - Nurse Practitioner 7012340466 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F339224-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vijaya Nama M.D PA CurrentSince Aug 6, 2019 Accepting new patients
Rockland Medical Group, PLLC PastSince Apr 15, 2017 Accepting new patients
BP Immediate Medical Care, PC Past Accepting new patients

Locations

4800 N Galloway Ave
Ste 300
Mesquite, TX 75150
Phone (972) 587-9846

Interoperability endpoints

  • Direct secure messaging: siby.thomas.1@14525.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/14525/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429401600000",
    "number": "1497140867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SUFFERN LN",
            "city": "GARNERVILLE",
            "state": "NY",
            "postal_code": "109231311",
            "telephone_number": "845-825-6539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SUFFERN LN",
            "city": "GARNERVILLE",
            "state": "NY",
            "postal_code": "109231311",
            "telephone_number": "845-429-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "SIBY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2015-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F339224-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garnerville, NY

Sources for this page

Verify at the official NPI Registry.