Active NPI
Mohamad Tanta, PA
- Physician Assistant
- Worcester, MA
National Provider Identifier
1225734122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA100624
- Practice address
- 19 Foster St
Worcester, MA 01608-1715 - Phone
- (508) 890-8855
- NPI assigned
- Feb 1, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA100624 | MA | Primary |
Addresses
Primary practice location
19 Foster St
Worcester, MA 01608-1715
Mailing address
19 Foster St
Worcester, MA 01608-1715
Phone (508) 890-8855
Other practice location 1
123 Summer St
Worcester, MA 01608-1216
Phone (508) 363-5000
Other practice location 2
281 Lincoln St
Worcester, MA 01605-2138
Phone (508) 334-5916
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA100624 | MA | MD | Physician Assistant |
Organizations & group practices 1
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.
-
- Emergency Medicine Physician
- Worcester, MA
- NPI 1730885252
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780358400000",
"number": "1225734122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 FOSTER ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016081715",
"telephone_number": "508-890-8855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 FOSTER ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016081715",
"telephone_number": "508-890-8855"
}
],
"practiceLocations": [
{
"address_1": "123 Summer St",
"address_purpose": "LOCATION",
"city": "Worcester",
"state": "MA",
"postal_code": "016081216",
"country_code": "US",
"telephone_number": "508-363-5000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "281 Lincoln St",
"address_purpose": "LOCATION",
"city": "Worcester",
"state": "MA",
"postal_code": "016052138",
"country_code": "US",
"telephone_number": "508-334-5916",
"fax_number": "508-793-6326",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TANTA",
"first_name": "MOHAMAD",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-02-01",
"last_updated": "2026-06-02",
"certification_date": "2026-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "PA100624",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.