Active NPI
Julie I Tavares
- Respite Care
- Medford, NY
National Provider Identifier
1609432301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Respite Care
- Practice address
- 42 Ashton Rd
Medford, NY 11763-1002 - Phone
- (631) 334-3520
- NPI assigned
- May 17, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Homemaker | 376J00000X | |||
| Respite Care | 385H00000X | Primary |
Addresses
Primary practice location
42 Ashton Rd
Medford, NY 11763-1002
Mailing address
42 Ashton Rd
Medford, NY 11763-1002
Phone (631) 334-3520
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 81-1025305 | Medicaid | NY | |
| 81-1025305 | Other | NY | SOLE PROP |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558051200000",
"number": "1609432301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42 ASHTON RD",
"city": "MEDFORD",
"state": "NY",
"postal_code": "117631002",
"telephone_number": "631-334-3520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42 ASHTON RD",
"city": "MEDFORD",
"state": "NY",
"postal_code": "117631002",
"telephone_number": "631-334-3520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAVARES",
"first_name": "JULIE",
"middle_name": "I",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-17",
"last_updated": "2019-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": null,
"license": null,
"primary": false
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "81-1025305",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOLE PROP",
"identifier": "81-1025305",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Medford, NY
- Vanessa Taboada
- Edmund Tam, RPH
- Hajar Taman
- Michael John Tamer Jr., PHARM D.
- Danielle Tanzi, LCSW
- Alexis Tedesco
- Tender Loving Care Health Care Services of Long Island, LLC (Staff Builders Services)
- Tender Loving Care Health Care Services of Nassau Suffolk, LLC (Tender Loving Care, an Amedisys Company)
- Shannon Thayer, MS, CCC-SLP
- The Lake Grove School
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.