Mario G Loomis, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

198000 Issued in NY

Practice address

225 Dolson Ave
Suite 302
Middletown, NY 10940-6569

Phone

(845) 342-6884

Fax

(845) 342-4989

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780778522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 DOLSON AVE",
            "address_2": "SUITE 302",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109406569",
            "telephone_number": "845-342-6884",
            "fax_number": "845-342-4989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 DOLSON AVE",
            "address_2": "SUITE 302",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109406569",
            "telephone_number": "845-342-6884",
            "fax_number": "845-342-4989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOOMIS",
        "first_name": "MARIO",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "198000",
            "primary": true
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "PA",
            "license": "MD046328L",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NJ",
            "license": "69053",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01553864",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Lombardo, FNP
• Vanessa Lomedico, MSED
• Eric Lonergan, M.D.
• Danielle Marie Long, RN
• Loomis Plastic Surgery, PC
• Alicia Lynn Lopez, PTA
• Bibian Lopez
• Jasmine Lopez, OT
• Maria Lopez, LMSW
• Martha Elena Lopez

• Plastic Surgery Physician in Middletown, NY
• Providers in Middletown, NY by specialty
• Plastic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.