Individual provider Active NPI

Claire Johnston Tucker, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1326772872
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
028959-01 Issued in NY
Practice address
3959 Broadway
New York, NY 10032-1559
Phone
(212) 305-6628
NPI assigned
Jul 11, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 028959-01 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3959 Broadway
New York, NY 10032-1559

Mailing address

800 Chesapeake PL
Greenville, NC 27858-6239
Phone (252) 531-6332

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
Direct Messaging Address rfg9012@direct.nyp.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NC2 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
I20221207001686 NY Practitioner - Physician Assistant 0840669289 Reassigns benefits to 1 organization
I20260608000983 NC Practitioner - Physician Assistant 0840669289

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 110566
Durham, NC 27709

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
028959NYMDOccupational Therapist
028959-01NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York Physician Assistant CurrentSince Oct 25, 2022 Accepting new patients

Locations

3959 Broadway
New York, NY 10032
Phone (212) 304-7297

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

622 W 168th St
#2260
New York, NY 10032
Phone (212) 305-6204

Interoperability endpoints

  • Direct secure messaging: rfg9012@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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": "1657497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1326772872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CHESAPEAKE PL",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278586239",
            "telephone_number": "252-531-6332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321559",
            "telephone_number": "212-305-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "CLAIRE",
        "middle_name": "JOHNSTON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-11",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "028959-01",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "3959 Broadway",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100321559",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "3959 Broadway",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100321559",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rfg9012@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "useOtherDescription": "Direct Address",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "3959 Broadway",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100321559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.