Individual provider Active NPI

Leslie Tyrie, M.D.

  • Surgery Physician
  • Newark, NJ
National Provider Identifier
1205162435
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
25MA08636200 Issued in NJ
Practice address
150 Bergen St
NJ Trauma Center, University Hospital, Mezz, M-234
Newark, NJ 07103-2496
Phone
(973) 972-0559
NPI assigned
Oct 22, 2009
Last updated
Sep 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25MA08636200 NJ Primary
Surgical Critical Care Physician 2086S0102X 233786 NY

Addresses

Primary practice location

150 Bergen St
NJ Trauma Center, University Hospital, Mezz, M-234
Newark, NJ 07103-2496

Mailing address

150 Bergen St
NJ Trauma Center, University Hospital, Mezz, M-234
Newark, NJ 07103-2496

Other practice location 1

150 55th St
Brooklyn, NY 11220-2508
Phone (718) 630-7942

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ltyrie433430@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101202000072 NJ Practitioner - Critical Care (Intensivists)Practitioner - General Surgery 4587850516 Reassigns benefits to 1 organization
I20190306003366 NY Practitioner - General SurgeryPractitioner - Hospice/Palliative CarePractitioner - Critical Care (Intensivists) 4587850516 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: General Surgery
Education
Rutgers New Jersey Medical School, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

20 Prospect Ave
Hackensack, NJ 07601-1997
Phone (551) 996-5045

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08636200NJMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jan 29, 2021 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Sep 1, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC Surgical Critical Care CurrentSince Sep 1, 2023 Accepting new patients
New York University Surgery CurrentSince Jan 29, 2021 Accepting new patients
NYU Langone Hospitals CurrentSince Feb 1, 2021 Accepting new patients
Downtown Bronx Medical Associates PC CurrentSince Jan 19, 2019 Accepting new patients
NYU Langone Hospitals Current Accepting new patients
NYU Langone Hospitals CurrentSince Feb 1, 2021 Accepting new patients
HMH Hospitals Corporation Past Accepting new patients

Locations

20 Prospect Ave
Hackensack, NJ 07601
Phone (201) 996-2816

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

3600 State Route 66
Fl 3
Neptune City, NJ 07753
Phone (732) 807-0463

234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7123

301 E 17th St
New York, NY 10003
Phone (212) 598-2454

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD
  • Direct secure messaging: leslie.tyrie@direct.hackensackmeridian.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1256169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1205162435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 BERGEN ST",
            "address_2": "NJ TRAUMA CENTER, UNIVERSITY HOSPITAL, MEZZ, M-234",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BERGEN ST",
            "address_2": "NJ TRAUMA CENTER, UNIVERSITY HOSPITAL, MEZZ, M-234",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032496",
            "telephone_number": "973-972-0559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 55th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112202508",
            "country_code": "US",
            "telephone_number": "718-630-7942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYRIE",
        "first_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-22",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA08636200",
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NY",
            "license": "233786",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ltyrie433430@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "150 55th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112202508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.