Active NPI
Assata Thomas
- Mental Health Counselor
- New York, NY
National Provider Identifier
1871066712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2090 Adam Clayton Powell Jr Blvd
New York, NY 10027-4990 - Phone
- (347) 963-7492
- NPI assigned
- Jan 3, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
2090 Adam Clayton Powell Jr Blvd
New York, NY 10027-4990
Mailing address
590 Avenues of Americas
New York, NY 10011-9904
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 804144973 | Medicaid | NY |
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2015
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2001 Story Ave
Apt 4O
Bronx, NY 10473-2023
535 Mack Ave
Kingsley, MI 49649-9220
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shine Medical Providers PC | Single Specialty | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546473600000",
"number": "1871066712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "590 AVENUES OF AMERICAS",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100119904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2090 ADAM CLAYTON POWELL JR BLVD",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100274990",
"telephone_number": "347-963-7492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "ASSATA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-03",
"last_updated": "2019-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "804144973",
"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 Jan 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.