Active NPI
Jeffrey Samuel Thomas, PA-C
- Physician Assistant
- Brooklyn, NY
National Provider Identifier
1780430496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 031595
- Practice address
- 374 Stockholm St
Brooklyn, NY 11237-4006 - Phone
- (516) 939-5611
- NPI assigned
- Apr 24, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 031595 | NY | Primary |
Addresses
Primary practice location
374 Stockholm St
Brooklyn, NY 11237-4006
Mailing address
17 Val Page St
Farmingdale, NY 11735-2116
Phone (516) 939-5611
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 031595 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713916800000",
"number": "1780430496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 VAL PAGE ST",
"city": "FARMINGDALE",
"state": "NY",
"postal_code": "117352116",
"telephone_number": "516-939-5611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "374 STOCKHOLM ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112374006",
"telephone_number": "516-939-5611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "JEFFREY",
"middle_name": "SAMUEL",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-04-24",
"last_updated": "2024-04-24",
"certification_date": "2024-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "031595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.