Individual provider Active NPI

Ngnam Julienne Tassa, PA-C

  • Medical Physician Assistant
  • New York, NY
National Provider Identifier
1073865887
Registry record updated Aug 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
015930 Issued in NY
Practice address
280 1St Ave
Bernstein Pavillion, 6TH Floor
New York, NY 10009-1834
Phone
(212) 420-2000
NPI assigned
Oct 4, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 015930 NY Primary

Addresses

Primary practice location

280 1St Ave
Bernstein Pavillion, 6TH Floor
New York, NY 10009-1834

Mailing address

7250 Parkway Dr
Ste 500
Hanover, MD 21076-1343
Phone (443) 949-0814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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
I20140319000842 DC Practitioner - Physician Assistant 9638300502 Reassigns benefits to 2 organizations
I20190712000967 MD Practitioner - Physician Assistant 9638300502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usacs Integrated Acute Care Services of Maryland LLCGroup PAC ID 4486900172, 178 clinicians

Practice addresses (Care Compare)

11890 Healing Way
Silver Spring, MD 20904-7917
Phone (240) 637-5070

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates, PA CurrentSince May 18, 2019 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince May 18, 2019 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince May 18, 2019 Accepting new patients

Locations

7600 Carroll Ave
Takoma Park, MD 20912
Phone (301) 791-7600

200 Memorial Ave
Westminster, MD 21157
Phone (410) 848-3000

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

100 Fairview Dr
Franklin, VA 23851
Phone (757) 516-1153

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503273600000",
    "number": "1073865887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7250 PARKWAY DR",
            "address_2": "STE 500",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210761343",
            "telephone_number": "443-949-0814",
            "fax_number": "443-949-0814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 1ST AVE",
            "address_2": "BERNSTEIN PAVILLION, 6TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100091834",
            "telephone_number": "212-420-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TASSA",
        "first_name": "NGNAM",
        "middle_name": "JULIENNE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-04",
        "last_updated": "2017-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "015930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.