NPIMap

Individual provider Active NPI

Tatiana Krasikov, M.D.

  • Cardiovascular Disease Physician
  • Fort Lee, NJ
National Provider Identifier
1205982949
Registry record updated Sep 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA08253200 Issued in NJ
Practice address
2200 Fletcher Avenue
Fort Lee, NJ 07024
Phone
(201) 461-6200
Fax
(201) 461-7204
NPI assigned
Jan 26, 2007
Last updated
Sep 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 224090 NY
Specialist 174400000X 25MA08253200 NJ
Cardiovascular Disease Physician 207RC0000X 25MA08253200 NJ Primary

Addresses

Primary practice location

2200 Fletcher Avenue
Fort Lee, NJ 07024

Mailing address

2200 Fletcher Avenue
Fort Lee, NJ 07024
Phone (201) 461-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071010000541 NJ Practitioner - Cardiovascular Disease (Cardiology) 7517053291 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Harvard Medical School, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2200 Fletcher Ave
Fort Lee, NJ 07024-5005
Phone (201) 461-6200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
224090NYMDSpecialist
25MA08253200NJMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Nov 7, 2018 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Nov 7, 2018 Accepting new patients
Humc Cardiovascular Partners, PC Cardiovascular Disease CurrentSince Jan 11, 2011 Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Past Accepting new patients

Locations

2200 Fletcher Ave
Fort Lee, NJ 07024
Phone (201) 461-6200

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

400 Frank W Burr Blvd
Ste 22
Teaneck, NJ 07666
Phone (201) 907-0442

Interoperability endpoints

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504656000000",
    "number": "1205982949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 FLETCHER AVENUE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "07024",
            "telephone_number": "201-461-6200",
            "fax_number": "201-461-7204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 FLETCHER AVENUE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "07024",
            "telephone_number": "201-461-6200",
            "fax_number": "201-461-7204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRASIKOV",
        "first_name": "TATIANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2017-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "224090",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA08253200",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA08253200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, NJ

Sources for this page

Verify at the official NPI Registry.