Individual provider Active NPI

Tinamarie Dzienkiewicz, P.A.-C

  • Physician Assistant
  • Hamilton, NJ
National Provider Identifier
1467882829
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00323100 Issued in NJ
Practice address
641 US Highway 130
Hamilton, NJ 08691-2101
Phone
(609) 568-9383
NPI assigned
Nov 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00323100 NJ Primary

Addresses

Primary practice location

641 US Highway 130
Hamilton, NJ 08691-2101

Mailing address

5000 Cox Rd
Glen Allen, VA 23060-9263
Phone (804) 968-5700

Other names 1

  • Tinamarie Gregorio Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address NJExchange@patientfirstclinics.com

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160211000296 NJ Practitioner - Physician Assistant 6204067267 Reassigns benefits to 2 organizations

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
Patient First New Jersey Physicians Group LLCGroup PAC ID 6608220322, 42 clinicians

Practice addresses (Care Compare)

606 Cross Keys Rd
Sicklerville, NJ 08081-9513
Phone (856) 237-1016

630 Mantua Pike
Woodbury, NJ 08096-3233
Phone (856) 812-2220

641 US Hwy 130
Hamilton, NJ 08691-2101
Phone (609) 568-9383

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00323100NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Patients First Maryland Physicians Group P C CurrentSince Oct 2, 2015 Accepting new patients
Patient First New Jersey Physicians Group LLC CurrentSince Jan 6, 2024 Accepting new patients
Patient First Maryland Physician'S Group PC CurrentSince Oct 2, 2015 Accepting new patients

Locations

641 US Highway 130
Hamilton, NJ 08691
Phone (609) 568-9383

630 Mantua Pike
Woodbury, NJ 08096
Phone (856) 812-2220

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

Interoperability endpoints

  • Direct secure messaging: njexchange@patientfirstclinics.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1467882829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "804-968-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 US HIGHWAY 130",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086912101",
            "telephone_number": "609-568-9383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIENKIEWICZ",
        "first_name": "TINAMARIE",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-22",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00323100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "NJExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "641 US Highway 130",
            "city": "Hamilton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "086912101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TINAMARIE",
            "last_name": "GREGORIO",
            "credential": "P.A. -C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hamilton, NJ

Sources for this page

Verify at the official NPI Registry.