Individual provider Active NPI

Avital Tsymbal, PA-C

  • Physician Assistant
  • Denville, NJ
National Provider Identifier
1710075114
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00088400 Issued in NJ
Practice address
25 Pocono Rd
Denville, NJ 07834-2954
Phone
(973) 625-6000
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00088400 NJ Primary
Physician Assistant 363A00000X 006330-1 NY

Addresses

Primary practice location

25 Pocono Rd
Denville, NJ 07834-2954

Mailing address

7 Penwood Rd
Livingston, NJ 07039-2607
Phone (973) 994-2684

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20050922000319 NJ Practitioner - Physician Assistant 3870525751 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excel Urgent Care of NJ LLCGroup PAC ID 9638396849, 21 clinicians

Practice addresses (Care Compare)

2624 Hwy 516
Old Bridge, NJ 08857-2306
Phone (732) 952-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
006330NYMDAcupuncturist
25MP00088400NJMDPhysician Assistant
006330-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Englewood, PC Past Accepting new patients
Englewood Medical Associates, Inc Past Accepting new patients
Englewood Medical Associates Inc Past Accepting new patients
Englewood Medical Associates Inc Past Accepting new patients

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212019200000",
    "number": "1710075114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 PENWOOD RD",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070392607",
            "telephone_number": "973-994-2684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 POCONO RD",
            "city": "DENVILLE",
            "state": "NJ",
            "postal_code": "078342954",
            "telephone_number": "973-625-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSYMBAL",
        "first_name": "AVITAL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2008-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00088400",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "006330-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denville, NJ

Sources for this page

Verify at the official NPI Registry.