Eliza Mae Tangonan, APN-C, PMHNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

26NJ00498900 Issued in NJ

Practice address

100 Walnut Ave Ste 210
Clark, NJ 07066-1269

Phone

(973) 620-2774

NPI assigned

May 19, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellness Management LLC 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Wellness Management LLC

  • Counselor
  • Livingston, NJ
  • NPI 1558709451

  NJ

  Medicare reassignment Care Compare group NPD
• Nephrological Associates, PA

  • Specialist
  • Florham Park, NJ
  • NPI 1740407923

  NJ

  Medicare reassignment NPD
• Northeast Kidney Care LLC

  • Internal Medicine Physician
  • Brick, NJ
  • NPI 1023889565

  NJ

  Medicare reassignment NPD
• The Kidney Group PA

  • Nephrology Physician
  • Newark, NJ
  • NPI 1326218546
  NPD (past)
• Vital Medical Forces of Dover PC

  • Internal Medicine Physician
  • Dover, NJ
  • NPI 1720007701
  NPD (past)

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1477964971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WALNUT AVE STE 210",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661269",
            "telephone_number": "973-620-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WALNUT AVE STE 210",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661269",
            "telephone_number": "973-620-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANGONAN",
        "first_name": "ELIZA",
        "middle_name": "MAE",
        "name_prefix": "Ms.",
        "credential": "APN-C, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-19",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00498900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suarez Osteopathic Medicine
• Summit Medical Group PA
• Summit Medical Group PA
• Susan G Blank, MD, LLC
• Lauren Takacs, LPC
• Lucy Tasharofi, PA
• Chirag Thakkar
• The Arc of Union County
• The Arc of Union County
• The Arc of Union County

• All providers in Clark, NJ
• Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; 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.