Individual provider Active NPI

Romy Tabacznik, NP

  • Nurse Practitioner
  • West Orange, NJ
National Provider Identifier
1518159474
Registry record updated Aug 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00138400 Issued in NJ
Practice address
5 Brook End Dr
West Orange, NJ 07052-1303
Phone
(973) 324-3000
NPI assigned
Aug 15, 2007
Last updated
Aug 15, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ00138400 NJ Primary

Addresses

Primary practice location

5 Brook End Dr
West Orange, NJ 07052-1303

Mailing address

245 Cass Ave
Mount Clemens, MI 48043-2118
Phone (586) 465-2879

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
I20070926001064 NJ Practitioner - Nurse Practitioner 1355436007 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.07 of 100Reported as group
Quality
76.5
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00138400NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Hospitalist Physicians of New Jersey PC CurrentSince Sep 19, 2009 Accepting new patients
Ipc Hospitalist Physicians of New Jersey PC CurrentSince Sep 19, 2009 Accepting new patients
Rwjbh Emergency Medicine Associates, LLC Nurse Practitioner CurrentSince Oct 13, 2021 Accepting new patients
Mayor Group, LLC Past Accepting new patients
Hospital Medicine Associates, P.C. Past Accepting new patients

Locations

225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204

600 River Ave
Lakewood, NJ 08701
Phone (732) 363-1900

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

151 Madison Ave
Morristown, NJ 07960
Phone (973) 656-2700

1 Riverview Plz
Red Bank, NJ 07701
Phone (732) 530-2204

1199 Pleasant Valley Way
West Orange, NJ 07052
Phone (973) 414-4755

5 Brook End Dr
West Orange, NJ 07052
Phone (973) 324-3000

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187136000000",
    "number": "1518159474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 CASS AVE",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432118",
            "telephone_number": "586-465-2879",
            "fax_number": "586-465-5424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BROOK END DR",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521303",
            "telephone_number": "973-324-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABACZNIK",
        "first_name": "ROMY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-15",
        "last_updated": "2007-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00138400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.