Individual provider Active NPI

Tara A Altschuler, NP

  • Family Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1518789338
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F351403 Issued in NY
Practice address
470 Ridgewood Ave
Staten Island, NY 10312-2119
Phone
(917) 533-3679
NPI assigned
Oct 31, 2024
Last updated
Oct 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F351403 NY Primary

Addresses

Primary practice location

470 Ridgewood Ave
Staten Island, NY 10312-2119

Mailing address

470 Ridgewood Ave
Staten Island, NY 10312-2119
Phone (917) 533-3679

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
I20250304002255 NY Practitioner - Nurse Practitioner 1850812033 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F351403NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rd Medical Professional Services PC CurrentSince Jan 1, 2025 Accepting new patients

Locations

1555 Rockaway Pkwy
Brooklyn, NY 11236
Phone (718) 307-5460

140 Beach 114th St
Rockaway Park, NY 11694
Phone (718) 945-4600

918 James St
Syracuse, NY 13203
Phone (315) 474-1561

612 Corporate Way
Ste 1M
Vly Cottage, NY 10989
Phone (718) 732-3634

Organizations & group practices 1

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": "1730332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1518789338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 RIDGEWOOD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103122119",
            "telephone_number": "917-533-3679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 RIDGEWOOD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103122119",
            "telephone_number": "917-533-3679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTSCHULER",
        "first_name": "TARA",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-31",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F351403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.