Individual provider Active NPI

Thomas Graham Conway, OTR/L

  • Occupational Therapist
  • Medford, NY
National Provider Identifier
1881258911
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
023529-1 Issued in NY
Practice address
12 Platinum CT
Medford, NY 11763-2247
Phone
(631) 286-6166
NPI assigned
Apr 24, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 023529-1 NY Primary

Addresses

Primary practice location

12 Platinum CT
Medford, NY 11763-2247

Mailing address

2468 Haff Ave
North Bellmore, NY 11710-2738
Phone (347) 254-9973

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230215001899 NY Practitioner - Occupational Therapist in Private Practice 0648642967 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Home Advantage Occupational Therapy, P.C.Group PAC ID 4385819218, 8 clinicians
Fox Rehabilitation Physical Therapy Services LLCGroup PAC ID 1355395179, 226 clinicians

Practice addresses (Care Compare)

12 Platinum Court
Medford, NY 11763-2247
Phone (516) 729-4834

1844 2ND Ave
New York, NY 10128-3862
Phone (877) 407-3422

3820 Bowne St
Flushing, NY 11354-5638
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
023529-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Home Advantage Occupational Therapy, P.C. CurrentSince Jan 1, 2023 Accepting new patients
Fox Rehabilitation Physical Therapy Services LLC Occupational Therapist CurrentSince May 1, 2024 Accepting new patients
Reliance Healthcare Occupational Therapist Past Accepting new patients

Locations

12 Platinum Ct
Medford, NY 11763
Phone (516) 729-4834

1415 Richmond Ave
Staten Island, NY 10314
Phone (212) 475-5540

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1881258911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2468 HAFF AVE",
            "city": "NORTH BELLMORE",
            "state": "NY",
            "postal_code": "117102738",
            "telephone_number": "347-254-9973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 PLATINUM CT",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632247",
            "telephone_number": "631-286-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "THOMAS",
        "middle_name": "GRAHAM",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-24",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "023529-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.