NPIMap

Individual provider Active NPI

Jared Tannenbaum, MD

  • Physical Medicine & Rehabilitation Physician
  • New York, NY
National Provider Identifier
1104288117
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
304733 Issued in NY
Practice address
150 Riverside Dr
New York, NY 10024-2298
Phone
(646) 505-3500
NPI assigned
Mar 28, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X FL
Family Medicine Physician 207Q00000X 304733 NY
Physical Medicine & Rehabilitation Physician 208100000X 304733 NY Primary

Addresses

Primary practice location

150 Riverside Dr
New York, NY 10024-2298

Mailing address

150 Eileen Way Unit 1
Syosset, NY 11791-5313
Phone (516) 855-5255

Other practice location 1

240 E 38th St Fl 15
New York, NY 10016-2708
Phone (212) 263-6110

Other practice location 2

150 Eileen Way Unit 1
Syosset, NY 11791-5313
Phone (516) 855-5255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200831002490 NY Practitioner - Family Practice 6608293097 Reassigns benefits to 1 organization
I20251121002043 CT Practitioner - Physical Medicine and Rehabilitation 6608293097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Miami, LM Miller School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

30 W 138TH St
New York, NY 10037-1710
Phone (201) 654-6397

50 Reserve Rd
Danbury, CT 06810-5182
Phone (203) 207-6400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.66 of 100Reported as group
Quality
73.72
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
304733NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Jared Tannenbaum MD LLC Physical Medicine & Rehabilitation CurrentSince Aug 4, 2025 Accepting new patients
National Health Rehabilitation LLC Physical Medicine & Rehabilitation CurrentSince Sep 1, 2023 Accepting new patients

Locations

30 W 138th St
New York, NY 10037
Phone (212) 690-7400

30 W 138th St
Ste 110
New York, NY 10037

32 Cedar Ln
Ossining, NY 10562
Phone (914) 762-1600

Organizations & group practices 2

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 10

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": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1104288117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 EILEEN WAY UNIT 1",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117915313",
            "telephone_number": "516-855-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 RIVERSIDE DR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100242298",
            "telephone_number": "646-505-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 E 38th St Fl 15",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100162708",
            "country_code": "US",
            "telephone_number": "212-263-6110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 Eileen Way Unit 1",
            "address_purpose": "LOCATION",
            "city": "Syosset",
            "state": "NY",
            "postal_code": "117915313",
            "country_code": "US",
            "telephone_number": "516-855-5255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANNENBAUM",
        "first_name": "JARED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "304733",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "304733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.