Mahnaz Chand Tantawi, MD
Individual provider Active NPI Internal Medicine Physician · Saddle Brook, NJ
NPI 1699823328 · NPPES record last updated Dec 20, 2013
Key facts
- NPI
- 1699823328
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- MA07672700 (NJ)
- Practice address
- 383 Market St
Suite 4B
Saddle Brook, NJ 07663-5300 - Phone
- (201) 712-7900
- Fax
- (201) 712-7902
- NPI assigned
- Jan 8, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
383 Market St
Saddle Brook, NJ 07663-5300
Phone (201) 712-7900
383 Market St
BLD B 4
Saddle Brook, NJ 07663-5941
Hospital & facility affiliations
- Hackensack University Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050629000402 | NJ | Practitioner - Internal Medicine | 9638115744 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA07672700 | NJ | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saddle Brook Medical Center PA | Current |
Accepting new patients | |
| Premier Medical of NJ | Past | Accepting new patients | |
| The Back Pain Center, LLC | Past | Accepting new patients | |
| Bergen Laparoscopic and General Surgery PA | Past | Accepting new patients | |
| Valley Physician Services, Inc. | Past | Accepting new patients | |
| Valley Physician Services PC | Internal Medicine | Past | Accepting new patients |
Locations
383 Market St
Bldg B4
Saddle Brook, NJ 07663
Phone (201) 712-7900
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MA07672700 | NJ | Yes |
Addresses
Primary practice location
383 Market St
Suite 4B
Saddle Brook, NJ 07663-5300
Mailing address
177 Summit Ave
Hackensack, NJ 07601-1311
Phone (201) 983-2455
Other providers in Saddle Brook, NJ
- Edwin J Sullivan
- Surgicore, LLC
- Surgistar Holdings LLC
- Lhiel Taga-Oc
- Brian Tanada
- Maryann Tawadros
- The Arc of Bergen and Passaic Counties, Inc.
- The Arc of Bergen and Passaic Counties, Inc.
- The Arc of Bergen and Passaic Counties, Inc.
- The Arc of Bergen and Passaic Counties, Inc.
All providers in Saddle Brook, NJ · Internal Medicine Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.