Individual provider Active NPI

Priyanka B Tandon, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1164892691
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
019075-1 Issued in NY
Practice address
1275 York Ave
New York, NY 10065-6007
Phone
(212) 639-3500
NPI assigned
Sep 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 019075-1 NY Primary

Addresses

Primary practice location

1275 York Ave
New York, NY 10065-6007

Mailing address

33 Butterfield Dr
Greenlawn, NY 11740-2010
Phone (631) 871-6611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160211000347 NY Practitioner - Physician Assistant 6002110038 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mskcc Regional NetworkGroup PAC ID 6608765144, 130 clinicians

Practice addresses (Care Compare)

650 Commack Rd
Commack, NY 11725-5404
Phone (631) 623-4034

Hospital & facility affiliations

  • Memorial Hospital for Cancer and Allied Diseases Hospital, New York, NY, CCN 330154

Merit-based Incentive Payment System (MIPS)

Final score
77.63 of 100Reported as group
Quality
66.91
Improvement activities
40
Cost
71.93

Merit-based Incentive Payment System (MIPS)

Final score
80.82 of 100Reported as group
Quality
71.2
Improvement activities
40
Cost
72.32

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019075-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai Hospital CurrentSince Nov 22, 2015 Accepting new patients
The Mount Sinai Hospital CurrentSince Nov 22, 2015 Accepting new patients

Locations

2715 30th Ave
Long Island City, NY 11102
Phone (718) 267-4808

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: ptandon36959@mskcc.direct-ci.com

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 5

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": "1443312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1164892691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 BUTTERFIELD DR",
            "city": "GREENLAWN",
            "state": "NY",
            "postal_code": "117402010",
            "telephone_number": "631-871-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANDON",
        "first_name": "PRIYANKA",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-27",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019075-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.