Individual provider Active NPI

Nicole Alexandra Salevitz Tagtmeyer, MD

  • Surgery Physician
  • New York, NY
National Provider Identifier
1699353805
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
343473 Issued in NY
Practice address
177 Fort Washington Ave
New York, NY 10032-3733
Phone
(602) 819-1494
NPI assigned
Mar 30, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 343473 NY Primary

Addresses

Primary practice location

177 Fort Washington Ave
New York, NY 10032-3733

Mailing address

177 Fort Washington Ave
New York, NY 10032-3733
Phone (602) 819-1494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20210802000055 PA Order and Referring Only - General SurgeryPractitioner - General Surgery 2769886555

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Arizona College of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

400 Kelby St
FL 9
Fort Lee, NJ 07024-2939

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1699353805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 FORT WASHINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323733",
            "telephone_number": "602-819-1494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 FORT WASHINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323733",
            "telephone_number": "602-819-1494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGTMEYER",
        "first_name": "NICOLE",
        "middle_name": "ALEXANDRA SALEVITZ",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "343473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.