Tamara Ann Bulleri, PSYCHIATRIC P.A.-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

25MP00757100 Issued in NJ

Practice address

545 Island Rd Ste 2B&3D
Ramsey, NJ 07446-2813

Phone

(201) 995-1004

NPI assigned

Oct 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Mrs. Tamara Ann Virgilio Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Medpsych Associates of New Jersey LLC

  • Mental Health Counselor
  • Ramsey, NJ
  • NPI 1649718685
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1013000728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 ISLAND RD STE 2B&3D",
            "city": "RAMSEY",
            "state": "NJ",
            "postal_code": "074462813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 ISLAND RD STE 2B&3D",
            "city": "RAMSEY",
            "state": "NJ",
            "postal_code": "074462813",
            "telephone_number": "201-995-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLERI",
        "first_name": "TAMARA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PSYCHIATRIC P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "1619",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C03461",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00757100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMARA",
            "last_name": "VIRGILIO",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "credential": "PSYCHIATRIC P.A.-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Brandi, MS., P.D.
• Maryanne Elizabeth Brennan-Spotts
• Christine Broderick, PT
• BSL PM NJ LLC
• Erna Buljko, MA, LAC
• Talitha Mariana Hedley Burns, DO
• Colette Keenan Byrnes, APN
• Chantal Cadestin
• Marisa Campanella-Harris
• Vanessa Nicole Canosa, PA-C

• All providers in Ramsey, NJ
• Medical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.