Individual provider Active NPI

Judith P Tiongco, MD

  • Internal Medicine Physician
  • West Orange, NJ
National Provider Identifier
1669591491
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA07819400 Issued in NJ
Practice address
741 Northfield Ave
Suite 201
West Orange, NJ 07052-1174
Phone
(908) 769-9600
Fax
(908) 769-9610
NPI assigned
Mar 29, 2007
Last updated
Nov 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 210225 NY
Internal Medicine Physician 207R00000X 25MA07819400 NJ Primary
Internal Medicine Physician 207R00000X MD059860L PA
Internal Medicine Physician 207R00000X 51779 CA

Addresses

Primary practice location

741 Northfield Ave
Suite 201
West Orange, NJ 07052-1174

Mailing address

PO Box 416457
Boston, MA 02241-6457

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070907000019 NJ Practitioner - Internal Medicine 5496848475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
210225NYMDInternal Medicine Physician
MD059860LPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group Internal Medicine CurrentSince Jan 15, 2016 Accepting new patients

Locations

25 E Willow St
Millburn, NJ 07041
Phone (973) 379-5055

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

465 South St
Ste 200
Morristown, NJ 07960
Phone (973) 971-7130

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.

Hospital & facility affiliations 5

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": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479859200000",
    "number": "1669591491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 NORTHFIELD AVE",
            "address_2": "SUITE 201",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521174",
            "telephone_number": "908-769-9600",
            "fax_number": "908-769-9610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIONGCO",
        "first_name": "JUDITH",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2016-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "210225",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07819400",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD059860L",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "51779",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.