Organization Active NPI

David Hom MD PLLC

  • Urology Physician
  • New York, NY
National Provider Identifier
1629112396
Registry record updated Apr 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
205838 1 Issued in NY
Legal business name
DAVID HOM MD PLLC
Practice address
251 E 33Rd St
LL
New York, NY 10016-4804
Phone
(212) 683-1008
Fax
(212) 683-2199
NPI assigned
Feb 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2008

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

Authorized official

Name
Dr. David Hom, MDNPI 1659351583
Title
MD
Phone
(212) 683-1008

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X 205838 1 NY Primary

Addresses

Primary practice location

251 E 33Rd St
LL
New York, NY 10016-4804

Mailing address

251 E 33Rd St
LL
New York, NY 10016-4804
Phone (212) 683-1008

Other identifiers 6

IdentifierTypeStateIssuer
1099211OtherNYGHI
205838OtherNYHIP
3610716OtherNYAETNA USHEALTHCARE
P2125864OtherNYOXFORD
36R401OtherNYEMPIRE BLUE SHIELD
02104974MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041130000957 NY Part B Supplier - Clinic/Group Practice 8729043880 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

333 E 34th St
Ofc 1L
New York, NY 10016
Phone (212) 683-1008

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1629112396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 E 33RD ST",
            "address_2": "LL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100164804",
            "telephone_number": "212-683-1008",
            "fax_number": "212-683-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E 33RD ST",
            "address_2": "LL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100164804",
            "telephone_number": "212-683-1008",
            "fax_number": "212-683-2199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID HOM MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "HOM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "212-683-1008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "NY",
            "license": "205838 1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "1099211",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "205838",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA USHEALTHCARE",
            "identifier": "3610716",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2125864",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE SHIELD",
            "identifier": "36R401",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02104974",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.