Individual provider Active NPI

Mark Thomas

  • Family Nurse Practitioner
  • Plainview, NY
National Provider Identifier
1649959487
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F352368-01 Issued in NY
Practice address
255 Executive Dr Ste 210B
Plainview, NY 11803-1711
Phone
(833) 433-2273
NPI assigned
Jul 17, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F352368-01 NY Primary

Addresses

Primary practice location

255 Executive Dr Ste 210B
Plainview, NY 11803-1711

Mailing address

255 Executive Dr Ste 210B
Plainview, NY 11803-1711
Phone (833) 433-2273

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
I20230914003896 NY Practitioner - Nurse Practitioner 3072977651 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sumaiyah Medical PCGroup PAC ID 2567630213, 6 clinicians
Samaritan Medical Services PCGroup PAC ID 7012016009, 341 clinicians

Practice addresses (Care Compare)

1 Somerset St
Huntington Station, NY 11746-8411
Phone (631) 271-3075

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (516) 705-2689

270 Union Ave
Holbrook, NY 11741-1823
Phone (631) 271-3075

50 Route 25a
Smithtown, NY 11787-1348
Phone (631) 862-3000

Hospital & facility affiliations

  • St Catherine of Siena Hospital Hospital, Smithtown, NY, CCN 330401

Merit-based Incentive Payment System (MIPS)

Final score
87.64 of 100Reported as group
Quality
76.13
Improvement activities
40
Cost
69.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F352368-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kim Medical of New York PLLC CurrentSince May 13, 2024 Accepting new patients
Sumaiyah Medical PC CurrentSince Jul 20, 2024 Accepting new patients
Samaritan Medical Services, P.C. CurrentSince Dec 25, 2023 Accepting new patients
Infinite Medical PC CurrentSince Aug 1, 2023 Accepting new patients

Locations

250 Skillman St
Ste 202
Brooklyn, NY 11205

11915 27th Ave
Flushing, NY 11354
Phone (631) 681-4754

270 Union Ave
Holbrook, NY 11741
Phone (631) 588-4442

1 Somerset St
Huntington Station, NY 11746
Phone (631) 271-3075

255 Executive Dr
Ste 210B
Plainview, NY 11803
Phone (516) 687-9563

10 Maple St
Prt Washingtn, NY 11050
Phone (917) 746-5942

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

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

Organizations & group practices 4

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 1

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": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1649959487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 EXECUTIVE DR STE 210B",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118031711",
            "telephone_number": "833-433-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 EXECUTIVE DR STE 210B",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118031711",
            "telephone_number": "833-433-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-17",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F352368-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

Verify at the official NPI Registry.