Organization Active NPI

Tightlynx LLC

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Brooklyn, NY
National Provider Identifier
1164831053
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X
Legal business name
TIGHTLYNX LLC
Practice address
374 Utica Ave
Brooklyn, NY 11213
Phone
(347) 854-9137
Fax
(718) 251-3909
NPI assigned
Aug 5, 2014
Last updated
Nov 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Authorized official

Name
Gyasi Jackson
Title
President
Phone
(347) 854-9137

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X NU Primary

Addresses

Primary practice location

374 Utica Ave
Brooklyn, NY 11213

Mailing address

374 Utica Ave
Brooklyn, NY 11213-5551
Phone (347) 854-9137

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190228002264 NY DME Supplier - Medical Supply Company 8820337272 Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

374 Utica Ave
Brooklyn, NY 11213
Phone (347) 854-9137

NPI Registry JSON

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636070400000",
    "number": "1164831053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 UTICA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112135551",
            "telephone_number": "347-854-9137",
            "fax_number": "718-251-3909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 UTICA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11213",
            "telephone_number": "347-854-9137",
            "fax_number": "718-251-3909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIGHTLYNX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-05",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "GYASI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-854-9137"
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.