NPIMap

Individual provider Active NPI

Ivan M. Tomek, MD

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Lebanon, NH
National Provider Identifier
1710913272
Registry record updated Aug 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
12087 Issued in NH
Practice address
1 Medical Center Dr
Lebanon, NH 03756-1000
Phone
(603) 650-8949
Fax
(603) 650-8869
NPI assigned
Jun 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 12087 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756-1000

Mailing address

1 Medical Center Dr
Lebanon, NH 03756-1000
Phone (603) 650-8949

Other identifiers 2

IdentifierTypeStateIssuer
1010011MedicaidVT
30203803MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, VT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060320000618 NH Practitioner - Orthopedic Surgery 8628085404 Reassigns benefits to 2 organizations
I20260513000026 VT Practitioner - Orthopedic Surgery 8628085404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Dalhousie University, Faculty of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alice Peck Day Memorial HospitalGroup PAC ID 6103737531, 132 clinicians
Ivan Tomek MD PLLCGroup PAC ID 0941779524, 2 clinicians

Practice addresses (Care Compare)

10 Alice Peck Day Dr
Lebanon, NH 03766-2900
Phone (603) 448-3121

426 Industrial Ave
Suite 130
Williston, VT 05495-4449
Phone (802) 753-2662

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.17 of 100Reported as group
Quality
84.29
Promoting interoperability
96
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
83.39 of 100Reported as group
Quality
72.51
Promoting interoperability
100
Improvement activities
40
Cost
55.45

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12087NHMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ivan Tomek MD PLLC Adult Reconstructive Orthopaedic Surgery Current Accepting new patients
Alice Peck Day Memorial Hospital CurrentSince Nov 1, 2014 Accepting new patients
Alice Peck Day Memorial Hospital Current Accepting new patients
Alice Peck Day Memorial Hospital CurrentSince Nov 1, 2014 Accepting new patients

Locations

10 Alice Peck Day Dr
Lebanon, NH 03766
Phone (603) 448-7440

5 Alice Peck Day Dr
Lebanon, NH 03766
Phone (603) 448-3996

426 Industrial Ave
Ste 130
Williston, VT 05495
Phone (518) 593-7466

Interoperability endpoints

  • Direct secure messaging: tomeki@apdmh.gwaydirect.com
  • FHIR API: https://edhwebportal.hitchcock.org/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: itomek17000@direct.dartmouth-hitchcock.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/CGAAED/Endpoint/CGAAED

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 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313971200000",
    "number": "1710913272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-8949",
            "fax_number": "603-650-8869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-8949",
            "fax_number": "603-650-8869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMEK",
        "first_name": "IVAN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2011-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "NH",
            "license": "12087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010011",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30203803",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.