Active NPI
Tara Chouake, MD
- Child & Adolescent Psychiatry Physician
- New York, NY
National Provider Identifier
1437683687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 299512
- Practice address
- 352 7TH Avenue
Floor 12a, Office H
New York, NY 10001 - Phone
- (646) 470-9273
- Fax
- (718) 540-4024
- NPI assigned
- Apr 14, 2017
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 299512 | NY | Primary |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 25MA11460200 | NJ | |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
352 7TH Avenue
Floor 12a, Office H
New York, NY 10001
Mailing address
352 7TH Ave FL 12a
Suite H
New York, NY 10001-5893
Phone (646) 470-9273
Other practice location 1
663 Palisade Ave
Cliffside Park, NJ 07010-3012
Phone (646) 470-9273
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA11460200 | NJ | MD | Child & Adolescent Psychiatry Physician |
| 299512 | NY | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717632000000",
"number": "1437683687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "352 7TH AVE FL 12A",
"address_2": "SUITE H",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100015893",
"telephone_number": "646-470-9273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "352 7TH AVENUE",
"address_2": "FLOOR 12A, OFFICE H",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10001",
"telephone_number": "646-470-9273",
"fax_number": "718-540-4024"
}
],
"practiceLocations": [
{
"address_1": "663 Palisade Ave",
"address_purpose": "LOCATION",
"city": "Cliffside Park",
"state": "NJ",
"postal_code": "070103012",
"country_code": "US",
"telephone_number": "646-470-9273",
"fax_number": "718-540-4024",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHOUAKE",
"first_name": "TARA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-14",
"last_updated": "2024-06-06",
"certification_date": "2024-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "NY",
"license": "299512",
"primary": true
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "NJ",
"license": "25MA11460200",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.