Sumra Tayebaly, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

25MA10428000 Issued in NJ

Practice address

419 N Harrison St Ste 201
Princeton, NJ 08540-3521

Phone

(609) 924-9300

NPI assigned

May 29, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Rutgers, Robert Woood Johnson Medical School, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Clinical Health Care Associates of New Jersey PCGroup PAC ID 0749180198, 793 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Medical Center of Princeton at Plainsboro Hospital, Plainsboro, NJ, CCN 310010

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Clinical Health Care Associates of New Jersey, P.C.

  • Family Medicine Physician
  • Cherry Hill, NJ
  • NPI 1447260435

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Princeton Medical Group,P.a.

  • Internal Medicine Physician
  • Princeton, NJ
  • NPI 1063513679

  Multi-Specialty

  Medicare reassignment NPD
• Clinical Health Care Associates of New Jersey, PC

  • Obstetrics & Gynecology Nurse Practitioner
  • Langhorne, PA
  • NPI 1538728357

  Multi-Specialty

  NPD
• Princeton Medical Group, P.a.

  • Non-Pharmacy Dispensing Site
  • Plainsboro, NJ
  • NPI 1144617937
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Princeton Healthcare System, a New Jersey Non-Profit Corporation

  • General Acute Care Hospital
  • Plainsboro, NJ
  • NPI 1689714255
  Care Compare affiliation

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1043622632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 N HARRISON ST",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085403594",
            "telephone_number": "609-924-9300",
            "fax_number": "609-430-9481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 N HARRISON ST STE 201",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085403521",
            "telephone_number": "609-924-9300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Liberty St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Plainsboro",
            "state": "NJ",
            "postal_code": "085361816",
            "country_code": "US",
            "telephone_number": "609-924-9300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYEBALY",
        "first_name": "SUMRA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-29",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MT207028",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA10428000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Siva Narayan Tallavajhala, R.PH.
• Tamerra P. Moeller, PHD, LLC
• Kevin Tan
• Sierra Tango, PA-C
• Sakina Mustafa Tayebali, PA-C
• Be'Ianka Jazz'E Taylor Gordon
• Lauren Taylor
• Telegenix Provider Group NJ, P.C.
• Julia Kate Temple, M.D.
• Harlan Tenenbaum

• Obstetrics & Gynecology Physician in Princeton, NJ
• Providers in Princeton, NJ by specialty
• Obstetrics & Gynecology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.