Taveras MD, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

226618 Issued in NY

Legal business name

TAVERAS MD, PC

Practice address

659 W 179TH St
New York, NY 10033-5735

Phone

(212) 568-1838

Fax

(212) 740-5163

NPI assigned

Mar 24, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Fernado T Taveras, MD

Title

President

Phone

(212) 568-1838

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacqueline Carreno, M.D.

  • Internal Medicine Physician
  • New York, NY
  • NPI 1831266535
  NPD (past)

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

{
    "created_epoch": "1174694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609993542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 W 179TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100335735",
            "telephone_number": "212-568-1838",
            "fax_number": "212-740-5163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "659 W 179TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100335735",
            "telephone_number": "212-568-1838",
            "fax_number": "212-740-5163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAVERAS MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TAVERAS",
        "authorized_official_first_name": "FERNADO",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-568-1838",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "226618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02365548",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Masoud Tavazoie, M.D., PH.D.
• Sohail Fakhr Tavazoie, M.D.
• Guido Tavazzi
• Marissa Rose Tavella, LMSW
• Catherine Tavello
• Mary Taveras-Garcia
• Ivette Taveras-Ozoria
• Ailin D Taveras I, CASAC-T
• Altagracia Taveras, R.N.
• Andrea Taveras

• Internal Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.