Individual provider Active NPI

Elizabeth Thomas, MD

  • Pediatrics Physician
  • Norwalk, CT
National Provider Identifier
1619939998
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
64553 Issued in CT
Practice address
120 Connecticut Ave
Norwalk, CT 06854-1525
Phone
(203) 899-1770
Fax
(203) 899-1779
NPI assigned
Apr 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 236719-1 NY
Pediatrics Physician 208000000X 64553 CT Primary

Addresses

Primary practice location

120 Connecticut Ave
Norwalk, CT 06854-1525

Mailing address

120 Connecticut Ave
Norwalk, CT 06854-1525
Phone (203) 899-1770

Other identifiers 1

IdentifierTypeStateIssuer
02748492MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060503000317 NY Practitioner - Pediatric MedicinePractitioner - Obstetrics/Gynecology 4284644410 Reassigns benefits to 1 organization
I20201223001867 CT Practitioner - Pediatric Medicine 4284644410 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64553CTMDPediatrics Physician
236719-1NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Norwalk Community Health Center Inc CurrentSince Nov 18, 2020 Accepting new patients
Samaritan Hospital of Troy, New York CurrentSince Jan 1, 2019 Accepting new patients

Locations

120 Connecticut Ave
Norwalk, CT 06854
Phone (203) 851-1000

1 Park St
Norwalk, CT 06851
Phone (203) 212-6533

57 Fillow St
Norwalk, CT 06850

1 Tallow Wood Dr
Clifton Park, NY 12065
Phone (518) 373-4444

713 Troy Schenectady Rd
Ste 304
Latham, NY 12110
Phone (518) 373-4448

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCDGCD
  • Direct secure messaging: elizabeth.thomas@nchc1.eclinicaldirectplus.com

Organizations & group practices 2

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": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1619939998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 CONNECTICUT AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068541525",
            "telephone_number": "203-899-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 CONNECTICUT AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068541525",
            "telephone_number": "203-899-1770",
            "fax_number": "203-899-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-04",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "236719-1",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "64553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02748492",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.