Active NPI
Tarek H Mardam-Bey, MD
- Orthopaedic Surgery Physician
- Tenafly, NJ
National Provider Identifier
1114076437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 1265861
- Practice address
- 2 Dean Drive
Tenafly, NJ 07670 - Phone
- (201) 569-0061
- Fax
- (201) 569-5602
- NPI assigned
- Jan 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 1265861 | NY | Primary |
| Pediatric Orthopaedic Surgery Physician | 207XP3100X | 1265861 | NY |
Addresses
Primary practice location
2 Dean Drive
Tenafly, NJ 07670
Mailing address
2 Dean Drive
Tenafly, NJ 07670
Phone (201) 569-0061
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6309305 | Medicaid | NJ | |
| 00306189 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1265861 | NY | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tarek Mardam Bey MD PC | Orthopaedic Surgery | Past | Accepting new patients |
| St Lukes Roosevelt Community Care | Orthopaedic Surgery | Past | Accepting new patients |
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.
-
- Orthopaedic Surgery Physician
- New York, NY
- NPI 1164571485
-
- Internal Medicine Physician
- New York, NY
- NPI 1740469246
Orthopaedic Surgery
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374019200000",
"number": "1114076437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 DEAN DRIVE",
"city": "TENAFLY",
"state": "NJ",
"postal_code": "07670",
"telephone_number": "201-569-0061",
"fax_number": "201-569-5602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 DEAN DRIVE",
"city": "TENAFLY",
"state": "NJ",
"postal_code": "07670",
"telephone_number": "201-569-0061",
"fax_number": "201-569-5602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARDAM-BEY",
"first_name": "TAREK",
"middle_name": "H",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-09",
"last_updated": "2013-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "NY",
"license": "1265861",
"primary": true
},
{
"code": "207XP3100X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
"state": "NY",
"license": "1265861",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6309305",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00306189",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tenafly, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.