Active NPI
Renuka H. Tank, M.D.
- Psychiatry Physician
- Bayville, NJ
National Provider Identifier
1063430627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 25MA06521400
- Practice address
- 160 Atlantic City Blvd
Bayville, NJ 08721-1229 - Phone
- (732) 349-1977
- Fax
- (732) 349-0841
- NPI assigned
- Jul 18, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 25MA06521400 | NJ | Primary |
Addresses
Primary practice location
160 Atlantic City Blvd
Bayville, NJ 08721-1229
Mailing address
160 Atlantic City Blvd
Bayville, NJ 08721-1229
Phone (732) 349-1977
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8826200 | Medicaid | NJ |
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200428000011 | NJ | Order and Referring Only - Psychiatry | 0941106207 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349654400000",
"number": "1063430627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 ATLANTIC CITY BLVD",
"city": "BAYVILLE",
"state": "NJ",
"postal_code": "087211229",
"telephone_number": "732-349-1977",
"fax_number": "732-349-0841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 ATLANTIC CITY BLVD",
"city": "BAYVILLE",
"state": "NJ",
"postal_code": "087211229",
"telephone_number": "732-349-1977",
"fax_number": "732-349-0841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANK",
"first_name": "RENUKA",
"middle_name": "H.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-18",
"last_updated": "2012-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NJ",
"license": "25MA06521400",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8826200",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bayville, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.