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DR. TIMOTHY JOHN MOSOMILLO D.O. N.M.M. NPI 1619900867


NPI Information

NPI: 1619900867
Provider Name: DR. TIMOTHY JOHN MOSOMILLO, D.O., N.M.M.
Classification: Neuromusculoskeletal Medicine, Sports Medicine - 204C00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
426 GREAT EAST NECK RD
SUITE C
WEST BABYLON, NY
ZIP 11704
Phone: (631) 661-6611
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DR. Timothy John Mosomillo, D.O., N.M.M. is a neuromusculoskeletal medicine sports medicine in West Babylon, NY with 35 years of experience. The provider is a Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician trained to be responsible for the continuous care in the field of sports medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine and integrates each of these into the management of the individual engaged in physical exercise (sports) whether as an individual or in team participation. Source: American Osteopathic Association Additional Resources: AOA Osteopathic Board Certification in Neuromusculoskeletal Medicine; https://certification.osteopathic.org/sports-medicine/ DR. Timothy John Mosomillo, D.O., N.M.M. NPI is 1619900867. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
Graduation Year:1989

The provider's business location address is:

426 GREAT EAST NECK RD
SUITE C
WEST BABYLON, NY
ZIP 11704-626
Phone: (631) 661-6611
Fax: (631) 661-5504

The NPI 1619900867 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/9/2006 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1204C00000XNeuromusculoskeletal Medicine, Sports Medicine185229NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1W86941MEDICARE ID-TYPE UNSPECIFIED
2F93707MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.