Individual provider Active NPI

Nicholas W Tinker, FNP-BC

  • Family Nurse Practitioner
  • Sparta, NJ
National Provider Identifier
1245004936
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ14957800 Issued in NJ
Practice address
89 Sparta Ave
Sparta, NJ 07871-1777
Phone
(973) 729-2121
NPI assigned
Nov 13, 2023
Last updated
Nov 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ14957800 NJ Primary
Registered Nurse 163W00000X 26NR18697600 NJ

Addresses

Primary practice location

89 Sparta Ave
Sparta, NJ 07871-1777

Mailing address

15 Chickadee Rd
Budd Lake, NJ 07828-2601
Phone (862) 268-7793

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20231228000399 NJ Practitioner - Nurse Practitioner 8628428042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Premier Health Associates LLCGroup PAC ID 0840283008, 45 clinicians

Practice addresses (Care Compare)

123 Newton Sparta Rd
Newton, NJ 07860-2769
Phone (973) 579-6300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NR18697600NJMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Associates LLC CurrentSince Jan 2, 2024 Accepting new patients
Premier Health Associates, LLC CurrentSince Jan 2, 2024 Accepting new patients

Locations

225 State Rt 23 S
Ste 1C
Hamburg, NJ 07419
Phone (973) 209-1550

123 Newton Sparta Rd
Newton, NJ 07860
Phone (973) 579-1000

532 Lafayette Rd
Ste 300
Sparta, NJ 07871
Phone (973) 940-0423

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EDJHBA
  • Direct secure messaging: nicholastinker@premiernj.allscriptsdirect.net

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

Hospital & facility affiliations 3

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": "1699833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1245004936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CHICKADEE RD",
            "city": "BUDD LAKE",
            "state": "NJ",
            "postal_code": "078282601",
            "telephone_number": "862-268-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 SPARTA AVE",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078711777",
            "telephone_number": "973-729-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINKER",
        "first_name": "NICHOLAS",
        "middle_name": "W",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-13",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ14957800",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR18697600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparta, NJ

Sources for this page

Verify at the official NPI Registry.