Individual provider Active NPI

Tziporah Vered Thall

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1487721007
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
003562 Issued in NY
Practice address
100 Ross St
Brooklyn, NY 11211-7672
Phone
(718) 387-7628
Fax
(718) 387-0780
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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 003562 NY Primary

Addresses

Primary practice location

100 Ross St
Brooklyn, NY 11211-7672

Mailing address

100 Ross St
Brooklyn, NY 11211-7672
Phone (718) 387-7628

Other practice location 1

26901 76th Ave
New Hyde Park, NY 11040-1433
Phone (718) 470-3572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20230407000598 NY Practitioner - Physician Assistant 7618342569 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Feb 27, 2023 Accepting new patients
Allied Physicians Group, PLLC Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

26901 76th Ave
New Hyde Park, NY 11040
Phone (718) 470-3000

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: tziporah.thall.1@29151.direct.athenahealth.com

Organizations & group practices 3

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1487721007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ROSS ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112117672",
            "telephone_number": "718-387-7628",
            "fax_number": "718-387-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ROSS ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112117672",
            "telephone_number": "718-387-7628",
            "fax_number": "718-387-0780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26901 76th Ave",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110401433",
            "country_code": "US",
            "telephone_number": "718-470-3572",
            "fax_number": "718-470-3572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THALL",
        "first_name": "TZIPORAH",
        "middle_name": "VERED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "003562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.