Individual provider Active NPI

Andrew Ming Tom

  • Physical Medicine & Rehabilitation Physician
  • White Plains, NY
National Provider Identifier
1821611815
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
328907-01 Issued in NY
Practice address
785 Mamaroneck Ave
White Plains, NY 10605-2523
Phone
(914) 597-2105
NPI assigned
May 25, 2020
Last updated
Oct 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 328907-01 NY Primary

Addresses

Primary practice location

785 Mamaroneck Ave
White Plains, NY 10605-2523

Mailing address

785 Mamaroneck Ave
White Plains, NY 10605-2523
Phone (914) 597-2105

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
I20240715000617 NY Practitioner - Physical Medicine and Rehabilitation 5991240954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
State University of New York Downstate Medical Center, 2019
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
328907-01NYMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Physical Medicine & Rehabilitation CurrentSince Jun 7, 2024 Accepting new patients
Montefiore Medical Center CurrentSince Jun 7, 2024 Accepting new patients
Winifred Masterson Burke Rehabilitation Hospital Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

785 Mamaroneck Ave
White Plains, NY 10605
Phone (914) 597-2257

967 N Broadway
Yonkers, NY 10701
Phone (914) 798-8956

Networks

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

Interoperability endpoints

  • Direct secure messaging: andrew.tom.1@14448.direct.athenahealth.com
  • Direct secure messaging: andrew.tom@989059681681412.direct.elationemr.com
  • Direct secure messaging: atom@montefioredirect.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1590364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1821611815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 MAMARONECK AVE",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106052523",
            "telephone_number": "914-597-2105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 MAMARONECK AVE",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106052523",
            "telephone_number": "914-597-2105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOM",
        "first_name": "ANDREW",
        "middle_name": "MING",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-25",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "328907-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.