Organization Active NPI

Thomas Davies DPM

  • Podiatric Clinic/Center
  • East Islip, NY
National Provider Identifier
1528227907
Registry record updated Aug 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
Legal business name
THOMAS DAVIES DPM
Practice address
252 E Main St
East Islip, NY 11730-2722
Phone
(631) 581-8828
Fax
(631) 581-0545
NPI assigned
Jun 2, 2008
Last updated
Aug 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2008

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

Authorized official

Name
Elaine Contona
Title
Office Manager
Phone
(631) 581-8828

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X NU Primary

Addresses

Primary practice location

252 E Main St
East Islip, NY 11730-2722

Mailing address

252 E Main St
East Islip, NY 11730-2722
Phone (631) 581-8828

Other identifiers 1

IdentifierTypeStateIssuer
00643389MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930049231 NY DME Supplier - Physician - Podiatry 7315150588 Practice locations: East Islip, NY

National Provider Directory

National Provider Directory

Locations

252 E Main St
East Islip, NY 11730
Phone (631) 581-8828

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219881600000",
    "number": "1528227907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 E MAIN ST",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302722",
            "telephone_number": "631-581-8828",
            "fax_number": "631-581-0545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 E MAIN ST",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302722",
            "telephone_number": "631-581-8828",
            "fax_number": "631-581-0545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS DAVIES DPM",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-02",
        "last_updated": "2008-08-28",
        "status": "A",
        "authorized_official_last_name": "CONTONA",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "631-581-8828"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00643389",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.