Michael Andrew Tavill, MD

Primary specialty

Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X

License

25MA06549000 Issued in NJ

Practice address

1131 Broad Street
Ste 103
Shrewsbury, NJ 07702

Phone

(732) 389-3388

Fax

(732) 389-3389

NPI assigned

Oct 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Otolaryngology

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

ENT and Allergy Associates LLPGroup PAC ID 0749193662, 431 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.45 of 100Reported as group

Quality

89.91

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.tavill@direct.entandallergy.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• ENT and Allergy Associates LLP

  • Otolaryngology Physician
  • Tarrytown, NY
  • NPI 1376598326

  NJ, Pediatric Otolaryngology

  Medicare reassignment Care Compare group NPD
• ENT and Allergy Associates of Pennsylvania PLLC

  • Allergy & Immunology Physician
  • Willow Grove, PA
  • NPI 1548098759

  Pediatric Otolaryngology

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1417030792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 WHITE PLAINS RD FL 4",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105915139",
            "telephone_number": "914-984-2546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 BROAD STREET",
            "address_2": "STE 103",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "07702",
            "telephone_number": "732-389-3388",
            "fax_number": "732-389-3389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVILL",
        "first_name": "MICHAEL",
        "middle_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0012X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "NJ",
            "license": "25MA06549000",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "NJ",
            "license": "25MA06549000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke Andrews Stratton, LSW
• Stephanie Strohmenger, DOCTOR
• Sunrise of Shrewsbury Opco, LLC
• Katherine Szema, M.D.
• Erica Elizabeth Szymanek, DNP, APN
• TDG Center for Dermatologic Care LLC
• Kelsie N Teehan
• The Arc of Monmouth
• The Sycamore Assisted Living
• The Therapy Institute, LLC

• Pediatric Otolaryngology Physician in Shrewsbury, NJ
• Providers in Shrewsbury, NJ by specialty
• Pediatric Otolaryngology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.

Verify at the official NPI Registry.