Individual provider Active NPI

Elizabeth Thomas

  • Psychiatric/Mental Health Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1629422241
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402834 Issued in NY
Practice address
784 Sheridan Ave
Brooklyn, NY 11208-3283
Phone
(954) 650-3920
NPI assigned
Apr 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 670776 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 402834 NY Primary

Addresses

Primary practice location

784 Sheridan Ave
Brooklyn, NY 11208-3283

Mailing address

784 Sheridan Ave
Brooklyn, NY 11208-3283
Phone (954) 650-3920

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ethomas372952@nyumc.direct-ci.com NYU Langone Hospitals

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
I20201014002405 NY Practitioner - Nurse Practitioner 7911327804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NYU Langone HospitalsGroup PAC ID 4981515699, 245 clinicians

Practice addresses (Care Compare)

301 E 17TH St
New York, NY 10003-3804
Phone (212) 598-2454

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
670776NYMDRegistered Nurse
402834NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NYU Langone Hospitals CurrentSince Jul 6, 2020 Accepting new patients
NYU Langone Hospitals CurrentSince Jul 6, 2020 Accepting new patients
NYU Langone Hospitals Registered Nurse Current Accepting new patients

Locations

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7185

301 E 17th St
New York, NY 10003
Phone (212) 460-0125

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: ethomas372952@nyumc.direct-ci.com

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.

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": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1629422241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "784 SHERIDAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112083283",
            "telephone_number": "954-650-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 SHERIDAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112083283",
            "telephone_number": "954-650-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-20",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "670776",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ethomas372952@nyumc.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "NYU Langone Hospitals",
            "address_1": "150 55th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112202559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.