NPIMap

Tasha Monique Anderson, PA-C

Individual provider Active NPI Physician Assistant · Baltimore, MD

NPI 1235451584 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1235451584
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
013877 (NY)
Practice address
4300 Belair Rd Ste a
Baltimore, MD 21206-6300
Phone
(410) 325-2100
Fax
(410) 630-5130
NPI assigned
Feb 26, 2010
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
HHS exclusion list flag
The National Provider Directory flags this NPI as appearing on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 013877 NY Yes

Addresses

Primary practice location

4300 Belair Rd Ste a
Baltimore, MD 21206-6300

Mailing address

5606 Belleville Ave
Gwynn Oak, MD 21207-6946
Phone (347) 432-7522

Other practice location 1

79-01 Broadway
Elmhurst Hospital Center
Elmhurst, NY 11373
Phone (718) 334-2555

Other identifiers

IdentifierTypeStateIssuer
C05296OtherMDMARYLAND LICENSE

Other providers in Baltimore, MD

All providers in Baltimore, MD · Physician Assistant in Maryland

Sources for this page

Verify at the official NPI Registry.