Active NPI
Mariano Nevarez-Tapia Jr., M.D.
- Psychiatry Physician
- Goshen, NY
National Provider Identifier
1487980066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 172451-1
- Practice address
- 61 Old Chester Rd
Goshen, NY 10924-5220 - Phone
- (845) 294-1045
- Fax
- (845) 294-5260
- NPI assigned
- Nov 2, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 172451-1 | NY | Primary |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 01058890A | IN |
Addresses
Primary practice location
61 Old Chester Rd
Goshen, NY 10924-5220
Mailing address
61 Old Chester Rd
Goshen, NY 10924-5220
Phone (845) 294-1045
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 172451-1 | NY | MD | Psychiatry Physician |
| 01058890A | IN | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257120000000",
"number": "1487980066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "61 OLD CHESTER RD",
"city": "GOSHEN",
"state": "NY",
"postal_code": "109245220",
"telephone_number": "845-294-1045",
"fax_number": "845-294-5260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "61 OLD CHESTER RD",
"city": "GOSHEN",
"state": "NY",
"postal_code": "109245220",
"telephone_number": "845-294-1045",
"fax_number": "845-294-5260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEVAREZ-TAPIA",
"first_name": "MARIANO",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-11-02",
"last_updated": "2009-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "172451-1",
"primary": true
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "IN",
"license": "01058890A",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goshen, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.