Individual provider Active NPI

Caitlin W Tomko, NP

  • Family Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1578056933
Registry record updated Aug 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
343444 Issued in NY
Practice address
750 E Adams St
Syracuse, NY 13210
Phone
(315) 464-4570
NPI assigned
Jun 11, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 22695925 NY
Family Nurse Practitioner 363LF0000X 343444 NY Primary

Addresses

Primary practice location

750 E Adams St
Syracuse, NY 13210

Mailing address

8132 Verbeck Dr
Manlius, NY 13104-9316
Phone (518) 681-1628

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181030002126 NY Practitioner - Nurse Practitioner 3870846322 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22695925NYMDCritical Care Medicine Registered Nurse
343444NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Familycare Medical Group, PC CurrentSince Feb 1, 2023 Accepting new patients
Suny Health Science Center at Syracuse Family CurrentSince Sep 9, 2018 Accepting new patients
Suny Health Science Center at Syracuse CurrentSince Sep 9, 2018 Accepting new patients

Locations

251 Salina Meadows Pkwy
Ste 100
Syracuse, NY 13212
Phone (315) 464-2000

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

4488 Onondaga Blvd
Syracuse, NY 13219
Phone (315) 492-5784

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": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534636800000",
    "number": "1578056933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8132 VERBECK DR",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131049316",
            "telephone_number": "518-681-1628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-464-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMKO",
        "first_name": "CAITLIN",
        "middle_name": "W",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2018-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NY",
            "license": "22695925",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "343444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.