Active NPI
Mary Grace M. Tolentino, NP-C
- Primary Care Nurse Practitioner
- Teaneck, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 26NJ00704900
- Practice address
- 618 Tilden Ave
Teaneck, NJ 07666-1846 - Phone
- (201) 982-1227
- NPI assigned
- Jan 27, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 26NJ00704900 | NJ | Primary |
Addresses
Primary practice location
618 Tilden Ave
Teaneck, NJ 07666-1846
Mailing address
618 Tilden Ave
Teaneck, NJ 07666-1846
Phone (201) 982-1227
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
21 Lincoln Ave
Elmwood Park, NJ 07407-1614
Phone (551) 277-4441
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ00704900 | NJ | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Daniel Korya MD LLC | Current | Accepting new patients | |
| Radius Telemed, LLC | Current | Accepting new patients | |
| Geriatrics and Longevity Treatment Specialist, PC | Current | Accepting new patients |
Locations
4700 N Habana Ave
Ste 505
Tampa, FL 33614
Phone (551) 277-4441
810 Main St
Hackensack, NJ 07601
Phone (201) 488-6728
211 Essex St
Ste 104
Hackensack, NJ 07601
Phone (201) 489-3888
55 Meadowlands Pkwy
Secaucus, NJ 07094
Phone (201) 325-6744
Organizations & group practices 4
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.
-
- Geriatric Medicine (Family Medicine) Physician
- Hackensack, NJ
- NPI 1306121504
-
- Internal Medicine Physician
- Passaic, NJ
- NPI 1184811390
-
- Internal Medicine Physician
- Jersey City, NJ
- NPI 1821618968
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485475200000",
"number": "1578000550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "618 TILDEN AVE",
"city": "TEANECK",
"state": "NJ",
"postal_code": "076661846",
"telephone_number": "201-982-1227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "618 TILDEN AVE",
"city": "TEANECK",
"state": "NJ",
"postal_code": "076661846",
"telephone_number": "201-982-1227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOLENTINO",
"first_name": "MARY GRACE",
"middle_name": "M.",
"name_prefix": "Miss",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-27",
"last_updated": "2017-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "NJ",
"license": "26NJ00704900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Teaneck, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2017; 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.