Individual provider Active NPI

Vivian F Tom, M.D.

  • Diagnostic Radiology Physician
  • New Hartford, NY
National Provider Identifier
1619082419
Registry record updated Oct 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
178104 Issued in NY
Practice address
1729 Burrstone Rd
New Hartford, NY 13413-1001
Phone
(315) 798-1500
Fax
(315) 798-1707
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 178104 NY Primary

Addresses

Primary practice location

1729 Burrstone Rd
New Hartford, NY 13413-1001

Mailing address

1729 Burrstone Rd
New Hartford, NY 13413-1001
Phone (315) 798-1500

Other identifiers 1

IdentifierTypeStateIssuer
120U21OtherNYHCFA

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

LicenseStateTypeSpecialty
178104NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Canal Radiology Associates, P.C. Diagnostic Radiology Past Accepting new patients
Community Radiology Past Accepting new patients
Beranbaum, Khilnani, Neistadt, Jacobs, Hertz and Sherman, M.D., P.C. Past Accepting new patients
DRS. Beranbaum, Khilnani, Neistadt, Jacobs, Hertz & Sherman, LLP Diagnostic Radiology Past Accepting new patients
North Shore Health System Medical Faculty Group Practice Inc Past Accepting new patients
Mill Basin Radiology PC PastSince Sep 15, 2014 Accepting new patients
Clifford Beinart, M.D PC Past Accepting new patients
University Radiology at Buffalo, Inc. Diagnostic Radiology Past Accepting new patients

Organizations & group practices 8

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413590400000",
    "number": "1619082419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 BURRSTONE RD",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134131001",
            "telephone_number": "315-798-1500",
            "fax_number": "315-798-1707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 BURRSTONE RD",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134131001",
            "telephone_number": "315-798-1500",
            "fax_number": "315-798-1707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOM",
        "first_name": "VIVIAN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2014-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "178104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HCFA",
            "identifier": "120U21",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hartford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.