Thomas Robert Sangiacomo, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

050341-1 Issued in NY

Practice address

102 N Main St
Cortland, NY 13045-1208

Phone

(607) 753-0011

Fax

(607) 753-0573

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 22, 2017 through May 22, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Thomas R. Sangiacomo DMD, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Cortland, NY
  • NPI 1336338995
  NPD (past) Authorized official

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942393905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 N MAIN ST",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130451208",
            "telephone_number": "607-753-0011",
            "fax_number": "607-753-0573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N MAIN ST",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130451208",
            "telephone_number": "607-753-0011",
            "fax_number": "607-753-0573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANGIACOMO",
        "first_name": "THOMAS",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "050341-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02608097",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nada M. Salman, MD
• Adrienne L Salomon, DO
• Sherrie Rita Saluc, LCSW
• Pamela Lynn Sanders, LCSW
• David Sanford
• Viveka Sareen, M.D.
• Gabrielle Satterly, LCSW
• Alicia Sautner
• Laura Sawyer, LMSW, CASAC
• Patricia Lynn Schaap, LMSW

• Oral and Maxillofacial Surgery (Dentist) in Cortland, NY
• Providers in Cortland, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.