Thomas Michael Edwards, PA
Individual provider Active NPI Medical Physician Assistant · Warsaw, NY
NPI 1861661266 · NPPES record last updated Feb 29, 2008
Key facts
- NPI
- 1861661266
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 002004-1 (NY)
- Practice address
- 400 N Main St
Warsaw, NY 14569-1025 - Phone
- (585) 535-0051
- NPI assigned
- Feb 29, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002004-1 | NY | MD | Medical Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 002004-1 | NY | Yes |
Addresses
Primary practice location
400 N Main St
Warsaw, NY 14569-1025
Mailing address
2636 Clinton Street Rd
Attica, NY 14011-9728
Phone (595) 591-0852
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- Sofia Elbaamrani
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All providers in Warsaw, NY · Medical Physician Assistant in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 29, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.