NPIMap

Individual provider Active NPI

Thomas Dokubo Braide, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Willow Street, PA
National Provider Identifier
1598969404
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
MD444463 Issued in PA
Practice address
212 Willow Valley Lakes Drive
Suite 101
Willow Street, PA 17584-9674
Phone
(717) 464-0286
Fax
(717) 464-0617
NPI assigned
Jun 13, 2007
Last updated
Feb 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X MD444463 PA Primary

Addresses

Primary practice location

212 Willow Valley Lakes Drive
Suite 101
Willow Street, PA 17584-9674

Mailing address

212 Willow Valley Lakes Drive
Suite 101
Willow Street, PA 17584-9674
Phone (717) 464-0286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141118000560 PA Practitioner - Geriatric Medicine 2163644626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Lancaster General HospitalGroup PAC ID 1254240039, 520 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

2100 Harrisburg Pike
Lancaster, PA 17601-2644
Phone (717) 544-3113

2102 Harrisburg Pike
Lancaster, PA 17601-2644
Phone (717) 544-3113

2108 Harrisburg Pike
Suite 315
Lancaster, PA 17601-2644
Phone (717) 544-3555

2112 Harrisburg Pike
Lancaster, PA 17601-2644

317 Chestnut St
Quarryville, PA 17566-1184
Phone (717) 544-3555

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD444463PAMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster General Hospital CurrentSince Dec 15, 2014 Accepting new patients
Penn Medicine LGHP Geriatrics CurrentSince Aug 25, 2025 Accepting new patients
Lancaster General Hospital CurrentSince Dec 15, 2014 Accepting new patients
Lancaster General Hospital Current Accepting new patients
Lancaster General Medical Group Family Medicine Past Accepting new patients
Living Independence for the Elderly Pittsburgh Inc Past Accepting new patients

Locations

2112 Harrisburg Pike
Ste 312
Lancaster, PA 17601
Phone (717) 544-3022

555 N Duke St
Lancaster, PA 17602
Phone (717) 544-5945

317 Chestnut St
Quarryville, PA 17566
Phone (717) 544-3555

212 Willow Valley Lakes Dr
Ste 101
Willow Street, PA 17584
Phone (717) 464-0280

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14261/brand/6/csg/1/fhir/r4

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1598969404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 WILLOW VALLEY LAKES DRIVE",
            "address_2": "SUITE 101",
            "city": "WILLOW STREET",
            "state": "PA",
            "postal_code": "175849674",
            "telephone_number": "717-464-0286",
            "fax_number": "717-464-0617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 WILLOW VALLEY LAKES DRIVE",
            "address_2": "SUITE 101",
            "city": "WILLOW STREET",
            "state": "PA",
            "postal_code": "175849674",
            "telephone_number": "717-464-0286",
            "fax_number": "717-464-0617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAIDE",
        "first_name": "THOMAS",
        "middle_name": "DOKUBO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "PA",
            "license": "MD444463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Street, PA

Sources for this page

Verify at the official NPI Registry.