Individual provider Active NPI

Thomas Kuriakose, MD

  • Pediatric Critical Care Medicine Physician
  • New York, NY
National Provider Identifier
1891254736
Registry record updated Jun 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
317012 Issued in NY
Practice address
3959 Broadway
New York, NY 10032
Phone
(212) 305-5437
NPI assigned
Mar 19, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 279998 MA
Pediatric Critical Care Medicine Physician 2080P0203X 317012 NY Primary

Addresses

Primary practice location

3959 Broadway
New York, NY 10032

Mailing address

343 Edstan Way
Paramus, NJ 07652-5742
Phone (201) 421-6206

Other practice location 1

1 Boston Medical Center Place
Menino Building, Dowling 3 South Resident Mailboxes
Boston, MA 02118
Phone (617) 414-5946

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
I20250620002888 NY Practitioner - Pediatric Medicine 7012242175 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
317012NYMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Jun 5, 2025 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jun 5, 2025 Accepting new patients
Trustees of Columbia University in the City of New York Current Accepting new patients
Child Health Foundation of Boston, Inc. Pediatric Critical Care Medicine Past Accepting new patients

Locations

400 Kelby St
Fort Lee, NJ 07024
Phone (212) 304-6309

3959 Broadway
New York, NY 10032
Phone (212) 304-7297

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

Networks

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

Interoperability endpoints

  • Direct secure messaging: lea9061@direct.nyp.org
  • Direct secure messaging: lea9061@direct.weillcornell.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1891254736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 EDSTAN WAY",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076525742",
            "telephone_number": "201-421-6206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10032",
            "telephone_number": "212-305-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Boston Medical Center Place",
            "address_2": "Menino Building, Dowling 3 South Resident Mailboxes",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02118",
            "country_code": "US",
            "telephone_number": "617-414-5946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KURIAKOSE",
        "first_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "279998",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NY",
            "license": "317012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.