Individual provider Active NPI

Sam Thompson, M.D.

  • Internal Medicine Physician
  • Elmira, NY
National Provider Identifier
1821172362
Registry record updated Mar 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
195774 Issued in NY
Practice address
722 W Water St
Elmira, NY 14905-2435
Phone
(607) 271-2050
Fax
(607) 271-2099
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 195774 NY Primary

Addresses

Primary practice location

722 W Water St
Elmira, NY 14905-2435

Mailing address

425 Pennsylvania Ave
Elmira, NY 14904-1762
Phone (607) 732-1310

Other identifiers 1

IdentifierTypeStateIssuer
2504011OtherGHI

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100301000747 NY Practitioner - Family PracticePractitioner - Internal Medicine 1759426992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Arnot Medical Services PLLC Internal Medicine PastSince Jul 1, 2019 Accepting new patients
Arnot Ogden Medical Center Past Accepting new patients
Fort Edward Rescue Squad Inc Past Accepting new patients
Arnot Ogden Medical Center Internal Medicine Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425859200000",
    "number": "1821172362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 PENNSYLVANIA AVE",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149041762",
            "telephone_number": "607-732-1310",
            "fax_number": "607-733-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 W WATER ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149052435",
            "telephone_number": "607-271-2050",
            "fax_number": "607-271-2099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "SAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2015-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "195774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2504011",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

Verify at the official NPI Registry.