Active NPI
Thomas Walter Hodyl, M.D.
- Family Medicine Physician
- Copiague, NY
National Provider Identifier
1497849467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 212007
- Practice address
- 517 Oak St
Unit C.
Copiague, NY 11726-3244 - Phone
- (631) 842-6680
- Fax
- (631) 842-6682
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 212007 | NY | Primary |
Addresses
Primary practice location
517 Oak St
Unit C.
Copiague, NY 11726-3244
Mailing address
517 Oak St
Unit C.
Copiague, NY 11726-3244
Phone (631) 842-6680
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 113604525 | Other | TAX I.D. # |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 212007 | NY | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497849467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "517 OAK ST",
"address_2": "UNIT C.",
"city": "COPIAGUE",
"state": "NY",
"postal_code": "117263244",
"telephone_number": "631-842-6680",
"fax_number": "631-842-6682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "517 OAK ST",
"address_2": "UNIT C.",
"city": "COPIAGUE",
"state": "NY",
"postal_code": "117263244",
"telephone_number": "631-842-6680",
"fax_number": "631-842-6682"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODYL",
"first_name": "THOMAS",
"middle_name": "WALTER",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "212007",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX I.D. #",
"identifier": "113604525",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Copiague, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.