NPIMap

Organization Active NPI

Thomas D Maher MD PLLC

  • Internal Medicine Physician
  • Skaneateles, NY
National Provider Identifier
1700044344
Registry record updated May 30, 2008
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Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
127236-1 Issued in NY
Legal business name
THOMAS D MAHER MD PLLC
Practice address
1990 W Lake Rd
Skaneateles, NY 13152-9674
Phone
(315) 391-6645
NPI assigned
May 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2008

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

Authorized official

Name
Thomas D Maher, MD
Title
Sole Member
Phone
(315) 391-6645

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 127236-1 NY Primary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X 127236-1 NY

Addresses

Primary practice location

1990 W Lake Rd
Skaneateles, NY 13152-9674

Mailing address

17 W Elizabeth St
PO Box 152
Skaneateles, NY 13152-1103
Phone (315) 391-6645

Other identifiers 1

IdentifierTypeStateIssuer
00507144MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1212105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212105600000",
    "number": "1700044344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 W ELIZABETH ST",
            "address_2": "PO BOX 152",
            "city": "SKANEATELES",
            "state": "NY",
            "postal_code": "131521103",
            "telephone_number": "315-391-6645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 W LAKE RD",
            "city": "SKANEATELES",
            "state": "NY",
            "postal_code": "131529674",
            "telephone_number": "315-391-6645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS D MAHER MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-30",
        "last_updated": "2008-05-30",
        "status": "A",
        "authorized_official_last_name": "MAHER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "315-391-6645",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "127236-1",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "127236-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00507144",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skaneateles, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.