Individual provider Active NPI

Thomas J Martin, PA-C

  • Medical Physician Assistant
  • New York, NY
National Provider Identifier
1790525939
Registry record updated May 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
550 1St Ave
New York, NY 10016-6402
Phone
(212) 263-5800
NPI assigned
May 27, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

550 1St Ave
New York, NY 10016-6402

Mailing address

4 Haypath Rd
Bethpage, NY 11714-1408
Phone (516) 713-8955

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
I20241025002995 NY Practitioner - Physician Assistant 4587197769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

530 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

560 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Sep 16, 2024 Accepting new patients
New York University CurrentSince Sep 16, 2024 Accepting new patients

Locations

700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: tmartin509004@nyumc.direct-ci.com

Organizations & group practices 2

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 7

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

NPI Registry JSON

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

{
    "created_epoch": "1716768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716768000000",
    "number": "1790525939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HAYPATH RD",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117141408",
            "telephone_number": "516-713-8955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-27",
        "last_updated": "2024-05-27",
        "certification_date": "2024-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.