Individual provider Active NPI

Ernest Tamajong, NP

  • Nurse Practitioner
  • Bear, DE
National Provider Identifier
1275671802
Registry record updated Sep 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
LP-0000155 Issued in DE
Practice address
2500 Wrangle Hill Rd
Ste 220
Bear, DE 19701-3837
Phone
(302) 437-6833
Fax
(302) 455-8550
NPI assigned
Feb 3, 2007
Last updated
Sep 5, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X LP-0000155 DE Primary
Adult Health Nurse Practitioner 363LA2200X SP016143 PA

Addresses

Primary practice location

2500 Wrangle Hill Rd
Ste 220
Bear, DE 19701-3837

Mailing address

2500 Wrangle Hill Rd
Ste 220
Bear, DE 19701-3837
Phone (302) 437-6833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170508001165 DE Practitioner - Nurse Practitioner 2961791009 Reassigns benefits to 2 organizations
I20180906000354 PA Practitioner - Nurse Practitioner 2961791009

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health First Medical CareGroup PAC ID 5890129100, 2 clinicians

Practice addresses (Care Compare)

2500 Wrangle Hill Rd
Suite 205
Bear, DE 19701-3838
Phone (302) 437-6833

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP-0000155DEMDNurse Practitioner
SP016143PAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vista Medical Services, Inc. CurrentSince Sep 1, 2018 Accepting new patients
Health First Medical Care Nurse Practitioner CurrentSince Aug 13, 2019 Accepting new patients
Milern Home Health Care Agency Past Accepting new patients

Locations

2500 Wrangle Hill Rd
Ste 205
Bear, DE 19701
Phone (302) 437-6833

2500 Wrangle Hill Rd
Ste 220
Bear, DE 19701
Phone (302) 275-2202

231 S Washington St
Millsboro, DE 19966
Phone (302) 645-4664

5651 Limestone Rd
Wilmington, DE 19808
Phone (302) 239-8583

Organizations & group practices 3

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 12

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": "1170460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1275671802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 WRANGLE HILL RD",
            "address_2": "STE 220",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "197013837",
            "telephone_number": "302-437-6833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 WRANGLE HILL RD",
            "address_2": "STE 220",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "197013837",
            "telephone_number": "302-437-6833",
            "fax_number": "302-455-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMAJONG",
        "first_name": "ERNEST",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-03",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LP-0000155",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP016143",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bear, DE

Sources for this page

Verify at the official NPI Registry.