Organization Active NPI

Thomas G Coyle

  • PACE Provider Organization
  • New York, NY
National Provider Identifier
1801217575
Registry record updated Dec 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
License
LA - 666357 Issued in NY
Legal business name
THOMAS G COYLE
Practice address
375 S End Ave
Apartment 25 U
New York, NY 10280-1014
Phone
(917) 566-2313
Fax
(212) 689-7010
NPI assigned
Dec 26, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2013

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

Authorized official

Name
Mr. Thomas Gerard Coyle
Title
Principal
Phone
(917) 566-2313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X LA - 666357 NY Primary

Addresses

Primary practice location

375 S End Ave
Apartment 25 U
New York, NY 10280-1014

Mailing address

375 South End Avenue
Apartment 25 U
New York, NY 10280
Phone (917) 566-2313

Other identifiers 1

IdentifierTypeStateIssuer
LA - 666357OtherNYLIFE HEALTH ACCIDENT LICENSE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1388016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388016000000",
    "number": "1801217575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 SOUTH END AVENUE",
            "address_2": "APARTMENT 25 U",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10280",
            "telephone_number": "917-566-2313",
            "fax_number": "212-689-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 S END AVE",
            "address_2": "APARTMENT 25 U",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "102801014",
            "telephone_number": "917-566-2313",
            "fax_number": "212-689-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS G COYLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-26",
        "last_updated": "2013-12-26",
        "status": "A",
        "authorized_official_last_name": "COYLE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "GERARD",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "917-566-2313",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": "NY",
            "license": "LA - 666357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIFE HEALTH ACCIDENT LICENSE",
            "identifier": "LA - 666357",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2013; 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.