Individual provider Active NPI

Maryjo G Thomson, D.O.

  • Family Medicine Physician
  • Morristown, NJ
National Provider Identifier
1982670618
Registry record updated Apr 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB056054 Issued in NJ
Practice address
261 James St
Suite 2a
Morristown, NJ 07960-6392
Phone
(973) 539-2468
Fax
(973) 539-7699
NPI assigned
Feb 23, 2006
Last updated
Apr 6, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB056054 NJ Primary

Addresses

Primary practice location

261 James St
Suite 2a
Morristown, NJ 07960-6392

Mailing address

PO Box 416457
Boston, MA 02241-6457

Other identifiers 1

IdentifierTypeStateIssuer
6628401MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20100929000124 NJ Practitioner - Family Practice 2769508670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596

261 James St
Suite 1a
Morristown, NJ 07960-6348
Phone (973) 539-0333

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB056054NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group Family Medicine CurrentSince Jul 1, 2014 Accepting new patients
Physicians Health Alliance PA Past Accepting new patients
Blair Medical Associates, P.a. Family Medicine Past Accepting new patients

Locations

170 Changebridge Rd
Bldg C3
Montville, NJ 07045
Phone (973) 575-5540

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

261 James St
Ste 2A
Morristown, NJ 07960
Phone (973) 539-2468

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428278400000",
    "number": "1982670618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 JAMES ST",
            "address_2": "SUITE 2A",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079606392",
            "telephone_number": "973-539-2468",
            "fax_number": "973-539-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMSON",
        "first_name": "MARYJO",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2015-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB056054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6628401",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, NJ

Sources for this page

Verify at the official NPI Registry.