Individual provider Active NPI

Liudmila Tizhgarten, FNP

  • Family Nurse Practitioner
  • Clifton, NJ
National Provider Identifier
1669177416
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ01465100 Issued in NJ
Practice address
1135 Main Ave FL 3
Clifton, NJ 07011-2353
Phone
(862) 238-8181
NPI assigned
Apr 3, 2023
Last updated
Jan 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 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 26NJ01465100 NJ Primary

Addresses

Primary practice location

1135 Main Ave FL 3
Clifton, NJ 07011-2353

Mailing address

421 Bloomfield Ave Apt A3
Verona, NJ 07044-2023
Phone (862) 220-8232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20230822000839 NJ Practitioner - Nurse Practitioner 2860854916 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clifton Medical Clinic IncGroup PAC ID 3274942487, 3 clinicians

Practice addresses (Care Compare)

1135 Main Ave
FL 3
Clifton, NJ 07011-2353
Phone (862) 238-8181

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01465100NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clifton Medical Clinic Inc CurrentSince Jun 1, 2023 Accepting new patients

Locations

1135 Main Ave
Fl 3
Clifton, NJ 07011
Phone (862) 238-8181

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": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1669177416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 BLOOMFIELD AVE APT A3",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070442023",
            "telephone_number": "862-220-8232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 MAIN AVE FL 3",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070112353",
            "telephone_number": "862-238-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIZHGARTEN",
        "first_name": "LIUDMILA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01465100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.