Individual provider Active NPI

Amy Tyberg, M.D.

  • Gastroenterology Physician
  • Rochelle Park, NJ
National Provider Identifier
1407015316
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
25MA10615300 Issued in NJ
Practice address
186 Rochelle Ave FL 2
Rochelle Park, NJ 07662-4122
Phone
(551) 996-1817
NPI assigned
Jun 5, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 10223100 NJ
Student in an Organized Health Care Education/Training Program 390200000X
Gastroenterology Physician 207RG0100X 25MA10615300 NJ Primary

Addresses

Primary practice location

186 Rochelle Ave FL 2
Rochelle Park, NJ 07662-4122

Mailing address

3600 Route 66 FL 3
Neptune, NJ 07753-2645

Other practice location 1

125 Paterson St Ste 5100
New Brunswick, NJ 08901-1962
Phone (732) 235-7784

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140603002083 NY Practitioner - Gastroenterology 2264655612 Reassigns benefits to 1 organization
I20180118000785 NJ Practitioner - GastroenterologyPractitioner - Internal Medicine 2264655612 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
New York Medical College, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hackensack Meridian Health Medical Group - Specialty Care PCGroup PAC ID 9133032519, 1,901 clinicians

Practice addresses (Care Compare)

186 Rochelle Ave
FL 2
Rochelle Park, NJ 07662-4111
Phone (551) 996-9230

Hospital & facility affiliations

  • Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001
  • St Joseph'S University Medical Center Inc Hospital, Paterson, NJ, CCN 310019

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10223100NJMDGastroenterology Physician
25MA10615300NJMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jul 27, 2023 Accepting new patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Feb 1, 2021 Accepting new patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Feb 1, 2021 Accepting new patients
St Josephs Medical PC CurrentSince Nov 11, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jul 27, 2023 Accepting new patients
North Medical PC Current Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Past Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

3600 State Route 66
Fl 3
Neptune City, NJ 07753
Phone (732) 807-0463

125 Paterson St
Ste 6100
New Brunswick, NJ 08901
Phone (732) 235-6561

125 Paterson St
New Brunswick, NJ 08901
Phone (732) 235-6511

125 Paterson St
Ste 5100
New Brunswick, NJ 08901
Phone (732) 235-7060

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

186 Rochelle Ave
Fl 2
Rochelle Park, NJ 07662
Phone (551) 996-1817

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

301 Prospect Ave
Ofc
Syracuse, NY 13203
Phone (315) 448-2876

Interoperability endpoints

  • Direct secure messaging: amy.tyberg@direct.hackensackmeridian.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 8

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 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": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1407015316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 ROUTE 66 FL 3",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077532645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 ROCHELLE AVE FL 2",
            "city": "ROCHELLE PARK",
            "state": "NJ",
            "postal_code": "076624122",
            "telephone_number": "551-996-1817"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Paterson St Ste 5100",
            "address_purpose": "LOCATION",
            "city": "New Brunswick",
            "state": "NJ",
            "postal_code": "089011962",
            "country_code": "US",
            "telephone_number": "732-235-7784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYBERG",
        "first_name": "AMY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "10223100",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MA10615300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochelle Park, NJ

Sources for this page

Verify at the official NPI Registry.