Individual provider Active NPI

Amy Tank, PA-C

  • Physician Assistant
  • Hackensack, NJ
National Provider Identifier
1043631831
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00316100 Issued in NJ
Practice address
20 Prospect Ave Ste 702
Hackensack, NJ 07601-1974
Phone
(908) 359-8980
NPI assigned
Dec 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 017012-1 NY
Physician Assistant 363A00000X 25MP00316100 NJ Primary

Addresses

Primary practice location

20 Prospect Ave Ste 702
Hackensack, NJ 07601-1974

Mailing address

20 Prospect Ave Ste 702
Hackensack, NJ 07601-1974
Phone (908) 359-8980

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
I20140603000203 NJ Practitioner - Physician Assistant 4789807181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Schweiger Dermatology PCGroup PAC ID 0143442806, 180 clinicians

Practice addresses (Care Compare)

105 Raider Blvd
Suite 203
Hillsborough, NJ 08844-1528
Phone (212) 283-3000

2 Hudson PL
Hoboken, NJ 07030-5594
Phone (212) 283-3000

20 Prospect Ave
Suite 702
Hackensack, NJ 07601-1974
Phone (212) 283-3000

712 E Bay Ave
Suite 18
Manahawkin, NJ 08050-3447
Phone (212) 283-3000

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
017012-1NYMDPhysician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1387497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1043631831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVE STE 702",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011974",
            "telephone_number": "908-359-8980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVE STE 702",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011974",
            "telephone_number": "908-359-8980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANK",
        "first_name": "AMY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-20",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017012-1",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00316100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.