Tanya Roth Adams, DO
Individual provider Active NPI Family Medicine Physician · Setauket, NY
NPI 1700879707 · NPPES record last updated Oct 24, 2016
Key facts
- NPI
- 1700879707
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 227867-1 (NY)
- Practice address
- 200 Main St
Suite 5
Setauket, NY 11733-2918 - Phone
- (631) 941-4480
- Fax
- (631) 941-4480
- NPI assigned
- Aug 24, 2005
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- New York College of Osteo Medicine of New York Institute of Technology, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
200 Main St
Suite 5
Setauket, NY 11733-2918
Phone (631) 941-4480
Hospital & facility affiliations
- Suny/Stony Brook University Hospital
- John T Mather Memorial Hospital of Port Jefferson
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- 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 |
|---|---|---|---|---|
| I20040408001055 | NY | Practitioner - Family Practice |
7315931839 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 227867-1 | NY | MD | Family Medicine Physician |
Practice roles (1 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vytaliz Medical | Current |
Accepting new patients |
Locations
3 E Evergreen Rd
Ste 1017
New City, NY 10956
Phone (201) 565-2533
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 227867-1 | NY | Yes |
Addresses
Primary practice location
200 Main St
Suite 5
Setauket, NY 11733-2918
Mailing address
200 Main St
Suite 5
Setauket, NY 11733-2918
Phone (631) 941-4480
Other providers in Setauket, NY
- 3 Village Chiropractic PLLC
- 3V Imaging, LLC
- Jacqueline Abraham
- Sean Richard Adams
- Kerri Albers
- Megan Alfiere
- Alice Miriam Marjorie Woodson White, LCSW, P.C.
- Alice Woodson White
- Alyssa Lynn Allen
All providers in Setauket, NY · Family Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2016. 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.