Active NPI
Tapan Parag Thaker, M.D.
- Student in an Organized Health Care Education/Training Program
- Newark, NJ
National Provider Identifier
1447820501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 111 Central Avenue Medical Education
Dept Floor D7
Newark, NJ 07102 - Phone
- (973) 877-5465
- NPI assigned
- Jun 30, 2021
- Reactivated
- May 2, 2024
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
111 Central Avenue Medical Education
Dept Floor D7
Newark, NJ 07102
Mailing address
111 Central Avenue Medical Education
Dept Floor D7
Newark, NJ 07102
Phone (973) 877-5465
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240718003468 | OH | Order and Referring Only - Critical Care (Intensivists) | 1658817333 | |
| I20260611003620 | FL | Order and Referring Only - Critical Care (Intensivists) | 1658817333 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714608000000",
"number": "1447820501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 CENTRAL AVENUE MEDICAL EDUCATION",
"address_2": "DEPT FLOOR D7",
"city": "NEWARK",
"state": "NJ",
"postal_code": "07102",
"telephone_number": "973-877-5465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 CENTRAL AVENUE MEDICAL EDUCATION",
"address_2": "DEPT FLOOR D7",
"city": "NEWARK",
"state": "NJ",
"postal_code": "07102",
"telephone_number": "973-877-5465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THAKER",
"first_name": "TAPAN PARAG",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-30",
"last_updated": "2024-05-02",
"certification_date": "2023-04-06",
"deactivation_date": "2023-04-06",
"reactivation_date": "2024-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.