Individual provider Active NPI

Tanya Dzubaty, PA-C

  • Physician Assistant
  • Fairfield, CT
National Provider Identifier
1588917066
Registry record updated Mar 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
002841 Issued in CT
Practice address
305 Black Rock Tpke
Fairfield, CT 06825-5508
Phone
(203) 337-2600
Fax
(203) 337-2666
NPI assigned
Oct 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2017

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 002841 CT Primary

Addresses

Primary practice location

305 Black Rock Tpke
Fairfield, CT 06825-5508

Mailing address

305 Black Rock Tpke
Fairfield, CT 06825-5508
Phone (203) 337-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20121226000348 CT Practitioner - Physician Assistant 2264685296 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehabilitation Associates IncGroup PAC ID 8022905322, shared by 2 NPIs, 525 clinicians
Ptsma IncGroup PAC ID 7911800180, shared by 11 NPIs, 173 clinicians
Orthopaedic Specialty Group PCGroup PAC ID 8820037898, 61 clinicians

Practice addresses (Care Compare)

1931 Black Rock Tpke
Fairfield, CT 06825-3506
Phone (203) 384-8681

222 Post Rd
Suite E
Fairfield, CT 06824-6245
Phone (203) 255-8888

305 Black Rock Tpke
Fairfield, CT 06825-5508
Phone (203) 337-2600

555 Bridgeport Ave
Shelton, CT 06484-4749
Phone (203) 922-1773

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.92 of 100Reported as group
Quality
58.9
Promoting interoperability
82
Improvement activities
40
Cost
75.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002841CTMDPsychologist
2841CTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mill Hill Medical Consultants Inc CurrentSince Mar 24, 2018 Accepting new patients
Northeast Medical Group, Inc. CurrentSince Mar 24, 2018 Accepting new patients
Orthopaedic Specialty Group, P.C. Past Accepting new patients
Orthoconnecticut, PLLC Past Accepting new patients

Locations

305 Black Rock Tpke
Fairfield, CT 06825
Phone (203) 337-2600

760 River Rd
Shelton, CT 06484
Phone (203) 337-2600

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Interoperability endpoints

  • Direct secure messaging: tdzubaty114366@direct.ynhh.org

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1350691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490313600000",
    "number": "1588917066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 BLACK ROCK TPKE",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068255508",
            "telephone_number": "203-337-2600",
            "fax_number": "203-337-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 BLACK ROCK TPKE",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068255508",
            "telephone_number": "203-337-2600",
            "fax_number": "203-337-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZUBATY",
        "first_name": "TANYA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-20",
        "last_updated": "2017-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "002841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.