NPIMap

Individual provider Active NPI

Tanner Joseph Tridico, MD

  • Internal Medicine Physician
  • Princeton, NJ
National Provider Identifier
1376581215
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA08057800 Issued in NJ
Practice address
419 N Harrison St
Princeton, NJ 08540-3521
Phone
(609) 924-9300
Fax
(609) 430-9481
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA08057800 NJ Primary

Addresses

Primary practice location

419 N Harrison St
Princeton, NJ 08540-3521

Mailing address

419 N Harrison St
Princeton, NJ 08540-3521
Phone (609) 924-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060711000017 NJ Practitioner - Internal Medicine 7315950532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Princeton Medical Group,P.a.Group PAC ID 6406835305, 36 clinicians

Practice addresses (Care Compare)

2 Research Way
Monroe Township, NJ 08831-6816
Phone 60992493003301

Hospital & facility affiliations

  • Penn Medicine Home Health Princeton Health Home health agency, Princeton, NJ, CCN 317045
  • Bayada Home Health Care, Inc. Home health agency, Cranford, NJ, CCN 317020
  • University Medical Center of Princeton at Plainsboro Hospital, Plainsboro, NJ, CCN 310010
  • Saint Peter'S University Hospital Hospital, New Brunswick, NJ, CCN 310070
  • Capital Health Medical Center - Hopewell Hospital, Pennington, NJ, CCN 310044
  • Robert Wood Johnson University Hospital at Hamilton Hospital, Hamilton, NJ, CCN 310110
  • Kessler Rehab Center Inpatient rehabilitation facility, West Orange, NJ, CCN 313025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA08057800NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton Medical Group,P.a. Internal Medicine CurrentSince May 8, 2017 Accepting new patients
Capital Health Medical Group Internal Medicine PastSince Sep 16, 2019 Accepting new patients
Princeton Medical Group, P.a. Past Accepting new patients

Locations

2 Research Way
Monroe Township, NJ 08831
Phone (609) 356-7200

3 Liberty St
Plainsboro, NJ 08536
Phone (609) 924-9300

419 N Harrison St
Princeton, NJ 08540
Phone (609) 921-9437

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://api.platform.athenahealth.com/12833/brand/1/csg/1/fhir/r4
  • Direct secure messaging: tanner.tridico.p1@direct.princetonmedicalgrp.nextgenshare.com

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1376581215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 N HARRISON ST",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085403521",
            "telephone_number": "609-924-9300",
            "fax_number": "609-430-9481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 N HARRISON ST",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085403521",
            "telephone_number": "609-924-9300",
            "fax_number": "609-430-9481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIDICO",
        "first_name": "TANNER",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA08057800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

Verify at the official NPI Registry.