Active NPI
Thomas P Fogarty, DO
- Internal Medicine Physician
- Canfield, OH
National Provider Identifier
1982680062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 34003449
- Practice address
- 3768 Boardman Canfield Rd
Canfield, OH 44406-8502 - Phone
- (330) 533-8490
- Fax
- (330) 533-8783
- NPI assigned
- Dec 20, 2005
- Last updated
- Jul 6, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 34003449 | OH | Primary |
Addresses
Primary practice location
3768 Boardman Canfield Rd
Canfield, OH 44406-8502
Mailing address
3768 Boardman Canfield Rd
Canfield, OH 44406-8502
Phone (330) 533-8490
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0538958 | Medicaid | OH | |
| 110131826 | Other | OH | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34003449 | OH | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Care Providers Inc | Internal Medicine | Past | Accepting new patients |
| John Balko and Associates Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Hermitage, PA
- NPI 1932105996
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278374400000",
"number": "1982680062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3768 BOARDMAN CANFIELD RD",
"city": "CANFIELD",
"state": "OH",
"postal_code": "444068502",
"telephone_number": "330-533-8490",
"fax_number": "330-533-8783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3768 BOARDMAN CANFIELD RD",
"city": "CANFIELD",
"state": "OH",
"postal_code": "444068502",
"telephone_number": "330-533-8490",
"fax_number": "330-533-8783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOGARTY",
"first_name": "THOMAS",
"middle_name": "P",
"name_prefix": "Mr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-20",
"last_updated": "2010-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "34003449",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0538958",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "110131826",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Canfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.