Individual provider Active NPI

Margaret Chifong Tam, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1215542923
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F345696-01 Issued in NY
Practice address
85 Venice Avenue
Staten Island, NY 10304
Phone
(212) 810-6419
NPI assigned
Sep 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F345696-01 NY Primary

Addresses

Primary practice location

85 Venice Avenue
Staten Island, NY 10304

Mailing address

85 Venice Avenue
Staten Island, NY 10304
Phone (212) 810-6419

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
I20211005000666 NY Practitioner - Nurse Practitioner 8729486873 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F345696-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MMC Hematology Oncology FPP CurrentSince Jul 1, 2021 Accepting new patients
Maimonides Faculty Practice Plan CurrentSince Jul 1, 2021 Accepting new patients

Locations

4508 16th Ave
Brooklyn, NY 11204
Phone (718) 972-8018

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

6300 8th Ave
Brooklyn, NY 11220
Phone (718) 765-2600

Gpo 27638
New York, NY 10087

Interoperability endpoints

  • Direct secure messaging: mtam129568@nyumc.direct-ci.com

Organizations & group practices 2

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": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1215542923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 VENICE AVENUE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10304",
            "telephone_number": "212-810-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 VENICE AVENUE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10304",
            "telephone_number": "212-810-6419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAM",
        "first_name": "MARGARET",
        "middle_name": "CHIFONG",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F345696-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.