Individual provider Active NPI

Thaine Robert Westbrook Woodrow, DO

  • Family Medicine Physician
  • Clarion, PA
National Provider Identifier
1962078675
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OT020590 Issued in PA
Practice address
24 Doctors LN Ste 202
Clarion, PA 16214-8574
Phone
(814) 226-2500
Fax
(814) 226-4505
NPI assigned
Jun 2, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 329657 NY
Family Medicine Physician 207Q00000X OT020590 PA Primary

Addresses

Primary practice location

24 Doctors LN Ste 202
Clarion, PA 16214-8574

Mailing address

24 Doctors LN Ste 202
Clarion, PA 16214-8574
Phone (814) 226-2500

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
I20240610000574 NY Practitioner - Emergency Medicine 2062888084 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buffalo Emergency Associates LLPGroup PAC ID 4981502515, 54 clinicians

Practice addresses (Care Compare)

565 Abbott Rd
Buffalo, NY 14220-2039
Phone (716) 826-7000

Hospital & facility affiliations

  • Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078
  • Kenmore Mercy Hospital Hospital, Kenmore, NY, CCN 330102
  • Mercy Hospital of Buffalo Hospital, Buffalo, NY, CCN 330279

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
329657NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Buffalo Emergency Associates LLP Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients

Locations

565 Abbott Rd
Buffalo, NY 14220
Phone (716) 826-7000

2157 Main St
Buffalo, NY 14214
Phone (716) 862-1501

2605 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 891-2315

Organizations & group practices 1

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1962078675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 DOCTORS LN STE 202",
            "city": "CLARION",
            "state": "PA",
            "postal_code": "162148574",
            "telephone_number": "814-226-2500",
            "fax_number": "814-226-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 DOCTORS LN STE 202",
            "city": "CLARION",
            "state": "PA",
            "postal_code": "162148574",
            "telephone_number": "814-226-2500",
            "fax_number": "814-226-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODROW",
        "first_name": "THAINE",
        "middle_name": "ROBERT WESTBROOK",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-02",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "329657",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OT020590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarion, PA

Sources for this page

Verify at the official NPI Registry.