Individual provider Active NPI

Shaun R Tamashausky, DO

  • Emergency Medicine Physician
  • Stratford, NJ
National Provider Identifier
1164616876
Registry record updated Sep 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
207P00000X Issued in NJ
Practice address
1 Medical Center Dr
Suite 162
Stratford, NJ 08084-1500
Phone
(856) 566-7121
Fax
(856) 566-6222
NPI assigned
Sep 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 207P00000X NJ Primary

Addresses

Primary practice location

1 Medical Center Dr
Suite 162
Stratford, NJ 08084-1500

Mailing address

1 Medical Center Dr
Suite 162
Stratford, NJ 08084-1500
Phone (856) 566-7121

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110804000306 NJ Practitioner - Emergency Medicine 3870762081 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
207P00000XNJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Services of New Jersey,Professional Association Emergency Medicine CurrentSince Feb 24, 2019 Accepting new patients
Emergency Physician Associates of South Jersey P C Emergency Medicine CurrentSince Jun 1, 2011 Accepting new patients

Locations

100 Townsend Ave
Berlin, NJ 08009
Phone (856) 322-3000

175 Madison Ave
Mount Holly, NJ 08060
Phone (609) 261-1660

718 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 833-3232

Interoperability endpoints

  • Direct secure messaging: stamashausky19219@directvirtua.org

Organizations & group practices 3

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": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1164616876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "SUITE 162",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841500",
            "telephone_number": "856-566-7121",
            "fax_number": "856-566-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "SUITE 162",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841500",
            "telephone_number": "856-566-7121",
            "fax_number": "856-566-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMASHAUSKY",
        "first_name": "SHAUN",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-05",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "207P00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, NJ

Sources for this page

Verify at the official NPI Registry.