Organization Active NPI

Ivan Tomek MD PLLC

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Williston, VT
National Provider Identifier
1972476174
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
Legal business name
IVAN TOMEK MD PLLC
Practice address
426 Industrial Ave Ste 130
Williston, VT 05495-4449
Phone
(802) 698-3762
NPI assigned
Sep 25, 2025
Last updated
Mar 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Authorized official

Name
Dr. Ivan Tomek, MDNPI 1710913272
Title
Manager
Phone
(603) 236-9867

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XS0114X Primary

Addresses

Primary practice location

426 Industrial Ave Ste 130
Williston, VT 05495-4449

Mailing address

426 Industrial Ave Ste 130
Williston, VT 05495-4449
Phone (802) 755-7171

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260513000004 VT Part B Supplier - Clinic/Group Practice 0941779524 Receives reassigned benefits from 2 practitioners
Practice locations: Williston, VT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1758758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773705600000",
    "number": "1972476174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 INDUSTRIAL AVE STE 130",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054954449",
            "telephone_number": "802-755-7171",
            "fax_number": "802-755-7274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 INDUSTRIAL AVE STE 130",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054954449",
            "telephone_number": "802-698-3762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVAN TOMEK MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-25",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A",
        "authorized_official_last_name": "TOMEK",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "603-236-9867",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.