Individual provider Active NPI

Tarik James, PA-C

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1043972276
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
653 E 92ND St
Brooklyn, NY 11236-1245
Phone
(718) 541-6276
NPI assigned
Oct 5, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

653 E 92ND St
Brooklyn, NY 11236-1245

Mailing address

653 E 92ND St
Brooklyn, NY 11236-1245
Phone (718) 541-6276

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220322001228 NY Practitioner - Physician Assistant 8224423603 Reassigns benefits to 4 organizations
I20230318000024 NJ Practitioner - Physician Assistant 8224423603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Modern Physician Services PCGroup PAC ID 6204140544, 55 clinicians

Practice addresses (Care Compare)

366 Knickerbocker Ave
Brooklyn, NY 11237-8055
Phone (646) 604-8161

3733 82ND St
Jackson Heights, NY 11372-7031
Phone (646) 604-8190

6721 Fresh Pond Rd
Ridgewood, NY 11385-4562
Phone (929) 468-9920

68 Graham Ave
Brooklyn, NY 11206-4017
Phone (646) 604-8130

916 Flatbush Ave
Brooklyn, NY 11226-4018
Phone (646) 604-8140

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fpa Hospital Based CurrentSince Mar 1, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2023 Accepting new patients

Locations

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

Organizations & group practices 8

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": "1633392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1043972276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 E 92ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112361245",
            "telephone_number": "718-541-6276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 E 92ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112361245",
            "telephone_number": "718-541-6276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "TARIK",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.