Individual provider Active NPI

Maryam Tuba

  • Community Health Worker
  • New York, NY
National Provider Identifier
1699418434
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
307 W 38TH St RM 817
New York, NY 10018-2913
Phone
(212) 695-4564
NPI assigned
Apr 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

307 W 38TH St RM 817
New York, NY 10018-2913

Mailing address

307 W 38TH St RM 817
New York, NY 10018-2913

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": "1650326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1699418434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 W 38TH ST RM 817",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100182913",
            "fax_number": "212-695-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 W 38TH ST RM 817",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100182913",
            "telephone_number": "212-695-4564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUBA",
        "first_name": "MARYAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.