Jack Tom, M.D.
NPI 1093724239 · Dermatology Physician · Stony Brook, NY
Enrolled with Medicare as Practitioner - Dermatology · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jack Tom, M.D. is a Dermatology Physician provider in Stony Brook, NY (NPI 1093724239).
Provider details
- NPI number
- 1093724239
- Entity type
- Individual
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 155342 (NY)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-08-05
- Last updated
- 2007-07-08
Frequently asked questions
- What is Jack Tom's NPI number?
- Jack Tom's National Provider Identifier (NPI) is 1093724239, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jack Tom's specialty?
- Jack Tom is listed in the NPPES registry with a primary specialty of Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Jack Tom located?
- Jack Tom's practice location on file with NPPES is 207 Hallock Rd, Stony Brook, NY 11790-3033.
- What is Jack Tom's phone number?
- The practice phone number listed in the NPPES registry for Jack Tom is (631) 444-0004.
- Does Jack Tom accept Medicare?
- Jack Tom is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Jack Tom's NPI active?
- Yes — Jack Tom's NPI (1093724239) is active in the NPPES registry as of the last update on 2007-07-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.