Individual provider Active NPI

Phyllis A Tarallo, DNP,DCC,FNP-C

  • Family Nurse Practitioner
  • Teaneck, NJ
National Provider Identifier
1043217300
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00125100 Issued in NJ
Practice address
718 Teaneck Rd
Teaneck, NJ 07666-4245
Phone
(212) 305-0448
Fax
(212) 342-5600
NPI assigned
Jul 1, 2005
Last updated
Feb 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 333859 NY
Primary Care Nurse Practitioner 363LP2300X 333859 NY
Women's Health Nurse Practitioner 363LW0102X 333859 NY
Family Nurse Practitioner 363LF0000X 26NJ00125100 NJ Primary

Addresses

Primary practice location

718 Teaneck Rd
Teaneck, NJ 07666-4245

Mailing address

PO Box 27036
New York, NY 10087-7036
Phone (212) 305-0914

Other identifiers 1

IdentifierTypeStateIssuer
0269026MedicaidNY

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090218000313 NJ Practitioner - Nurse Practitioner 9133113533 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Practice addresses (Care Compare)

1163 Rte 37
Suite A2
Toms River, NJ 08755-4974
Phone (732) 961-0010

475 Hwy 70
Suite 101
Lakewood, NJ 08701-5897
Phone (732) 364-8000

67 Hwy 37 W
Toms River, NJ 08755-6400

67 Rte 37
Toms River, NJ 08755-6400

94 Old Short Hills Rd
Livingston, NJ 07039-5672

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.53 of 100Reported as group
Quality
50.37
Promoting interoperability
100
Improvement activities
40
Cost
70.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
002915CTMDClinical Social Worker
26NJ00125100NJMDFamily Nurse Practitioner
333859NYMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC CurrentSince Mar 13, 2025 Accepting new patients
Regional Cancer Care Associates LLC CurrentSince Aug 7, 2017 Accepting new patients
Regional Cancer Care Associates LLC CurrentSince Aug 7, 2017 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Mar 13, 2025 Accepting new patients
The Trustees of Columbia University in the City of New York Family Past Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
St Lukes Roosevelt Hospital Center Past Accepting new patients

Locations

350 Engle St
Fl 6
Englewood, NJ 07631
Phone (201) 568-5250

25 Main St
Ste 601
Hackensack, NJ 07601
Phone (201) 510-0910

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

57 Kent Rd
Howell, NJ 07731
Phone (732) 364-1505

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

175 Madison Ave
Mount Holly, NJ 08060
Phone (609) 261-1660

718 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 833-3232

67 Route 37 W
Fl 2
Toms River, NJ 08755
Phone (732) 281-3373

99 State Route 37 W
Toms River, NJ 08755
Phone (732) 240-8000

Organizations & group practices 7

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 3

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": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1043217300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27036",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100877036",
            "telephone_number": "212-305-0914",
            "fax_number": "212-305-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 TEANECK RD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664245",
            "telephone_number": "212-305-0448",
            "fax_number": "212-342-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARALLO",
        "first_name": "PHYLLIS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DNP,DCC,FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-01",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "333859",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "333859",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "333859",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00125100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0269026",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.