Crystal Tank, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA10421000 Issued in NJ

Practice address

311 Bay Ave
MMG Internal Med
Glen Ridge, NJ 07028

Phone

(973) 748-9246

Fax

(973) 748-8755

NPI assigned

Apr 14, 2014

Last updated

Feb 17, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Internal Medicine

Education

State University of New York at Stony Brook, School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

MPV New Jersey MD Services PCGroup PAC ID 5991097669, 146 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Patient Care Home health agency, West Orange, NJ, CCN 317060
• Hackensack Meridian Mountainside Medical Hospital, Montclair, NJ, CCN 310054

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ctank292211@ahs.direct-ci.com

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.

• MPV New Jersey MD Services PC

  • General Practice Physician
  • Westwood, NJ
  • NPI 1215391271
  Medicare reassignment Care Compare group NPD
• Crystal Medical Group PA

  • Hematology & Oncology Physician
  • East Orange, NJ
  • NPI 1740546621
  NPD
• MPV New Jersey MD Services PC

  • Durable Medical Equipment & Medical Supplies
  • Bloomfield, NJ
  • NPI 1801542816
  NPD
• Orange Medical Group PA

  • Hematology & Oncology Physician
  • East Orange, NJ
  • NPI 1134148398

  Internal Medicine

  NPD (past)

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

• Montclair Hospital LLC

  dba HackensackUMC Mountainside

  • General Acute Care Hospital
  • Montclair, NJ
  • NPI 1982720249
  Care Compare affiliation
• Patient Care Medical Services, Inc.

  dba Patient Care

  • Home Health Agency
  • West Orange, NJ
  • NPI 1922089929
  Care Compare affiliation

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1043639453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419430",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022419430",
            "telephone_number": "201-967-8221",
            "fax_number": "201-483-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 BAY AVE",
            "address_2": "MMG INTERNAL MED",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "07028",
            "telephone_number": "973-748-9246",
            "fax_number": "973-748-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANK",
        "first_name": "CRYSTAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-14",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA10421000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Glen Ridge, NJ
• Providers in Glen Ridge, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; 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.