Individual provider Active NPI

Mara R. Tushaj, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1700152261
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
337237 Issued in NY
Practice address
111 E 210TH St
Rosenthal 2; Red Zone
Bronx, NY 10467-2401
Phone
(718) 920-4644
Fax
(718) 547-4773
NPI assigned
Mar 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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 337237 NY Primary

Addresses

Primary practice location

111 E 210TH St
Rosenthal 2; Red Zone
Bronx, NY 10467-2401

Mailing address

111 E 210TH St
Rosenthal 2; Red Zone
Bronx, NY 10467-2401
Phone (718) 920-4644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220620001713 NY Practitioner - Nurse Practitioner 7911386073 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2 Longview Ave
FL 2
White Plains, NY 10601-5000
Phone (914) 849-7600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince May 13, 2022 Accepting new patients
Montefiore Medical Center CurrentSince May 13, 2022 Accepting new patients
White Plains Physician Services PC CurrentSince Dec 12, 2023 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

111 E 210th St
#2
Bronx, NY 10467
Phone (718) 920-5057

185 Kisco Ave
Ste 300
Mount Kisco, NY 10549
Phone (914) 242-2020

2 Longview Ave
Fl 2
White Plains, NY 10601
Phone (914) 849-7539

2 Longview Ave
White Plains, NY 10601
Phone (914) 681-2727

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332979200000",
    "number": "1700152261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "address_2": "ROSENTHAL 2; RED ZONE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-4644",
            "fax_number": "718-547-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "address_2": "ROSENTHAL 2; RED ZONE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-4644",
            "fax_number": "718-547-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUSHAJ",
        "first_name": "MARA",
        "middle_name": "R.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-29",
        "last_updated": "2012-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "337237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.