Individual provider Active NPI

Kristin Thomson, PA

  • Physician Assistant
  • Hauppauge, NY
National Provider Identifier
1669400339
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
009995 Issued in NY
Practice address
88 Arkay Dr
Hauppauge, NY 11788
Phone
(631) 514-7600
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 009995 NY Primary

Addresses

Primary practice location

88 Arkay Dr
Hauppauge, NY 11788

Mailing address

1345 RXR PLZ FL 13TH
Uniondale, NY 11556-1301
Phone (516) 453-0435

Other identifiers 1

IdentifierTypeStateIssuer
02858588MedicaidNY

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
I20050609000983 NY Practitioner - Physician Assistant 4587607528 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.85 of 100Reported as group
Quality
79.23
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
009995NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Island Medical House Doctor PC PastSince Jul 7, 2008 Accepting new patients
Island Medical Physicians, PC Past Accepting new patients

Organizations & group practices 5

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1669400339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 RXR PLZ FL 13TH",
            "city": "UNIONDALE",
            "state": "NY",
            "postal_code": "115561301",
            "telephone_number": "516-453-0435",
            "fax_number": "646-846-3283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 ARKAY DR",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "11788",
            "telephone_number": "631-514-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMSON",
        "first_name": "KRISTIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02858588",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

Verify at the official NPI Registry.