Active NPI
Tina Fermano, PA
- Physician Assistant
- Hackensack, NJ
National Provider Identifier
1407298748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 25MP00311700
- Practice address
- 20 Prospect Ave Ste 702
Hackensack, NJ 07601-1974 - Phone
- (908) 359-8980
- NPI assigned
- Jul 29, 2013
- Last updated
- Sep 20, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 25MP00311700 | NJ | Primary |
Addresses
Primary practice location
20 Prospect Ave Ste 702
Hackensack, NJ 07601-1974
Mailing address
20 Prospect Ave
Hackensack, NJ 07601-1997
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2 Hudson PL
Hoboken, NJ 07030-5594
Phone (212) 283-3000
20 Prospect Ave
Suite 702
Hackensack, NJ 07601-1974
Phone (212) 283-3000
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MP00311700 | NJ | MD | Physician Assistant |
Organizations & group practices 1
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568937600000",
"number": "1407298748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 PROSPECT AVE",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076011997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 PROSPECT AVE STE 702",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076011974",
"telephone_number": "908-359-8980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERMANO",
"first_name": "TINA",
"name_prefix": "Ms.",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-29",
"last_updated": "2019-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NJ",
"license": "25MP00311700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hackensack, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.