Individual provider Active NPI

Tara Chouake, MD

  • Child & Adolescent Psychiatry Physician
  • New York, NY
National Provider Identifier
1437683687
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
299512 Issued in NY
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

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 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
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11460200NJMDChild & Adolescent Psychiatry Physician
299512NYMDChild & 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

Verify at the official NPI Registry.