Individual provider Active NPI

Tamara Aviles, MD

  • Obstetrics & Gynecology Physician
  • West New York, NJ
National Provider Identifier
1710409172
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25MA11089900 Issued in NJ
Practice address
419 66TH St
West New York, NJ 07093-2401
Phone
(201) 861-9229
NPI assigned
Jul 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 25MA11089900 NJ Primary

Addresses

Primary practice location

419 66TH St
West New York, NJ 07093-2401

Mailing address

3 University PLZ Ste 205
Hackensack, NJ 07601-6208
Phone (201) 833-3000

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210714003781 NJ Practitioner - Obstetrics/Gynecology 5890197776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excelcare Medical Associates PAGroup PAC ID 4284647868, 200 clinicians

Practice addresses (Care Compare)

718 Teaneck Rd
Teaneck, NJ 07666-4245
Phone (201) 227-6050

Hospital & facility affiliations

  • Holy Name Medical Center Hospital, Teaneck, NJ, CCN 310008

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA11089900NJMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Excelcare Medical Associates, PA CurrentSince Jul 19, 2021 Accepting new patients

Locations

574 Anderson Ave
Cliffside Park, NJ 07010
Phone (201) 943-4884

576 Anderson Ave
Cliffside Pk, NJ 07010
Phone (201) 941-7720

3 University Plz
Ste 205
Hackensack, NJ 07601

1 W Ridgewood Ave
Ste 203
Paramus, NJ 07652
Phone (201) 312-5243

718 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 833-3232

419 66th St
West New York, NJ 07093
Phone (201) 861-9229

Interoperability endpoints

  • Direct secure messaging: taviles@hnpn.ssdirect.aprima.com

Organizations & group practices 1

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 2

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": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1710409172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 UNIVERSITY PLZ STE 205",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016208",
            "telephone_number": "201-833-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 66TH ST",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070932401",
            "telephone_number": "201-861-9229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILES",
        "first_name": "TAMARA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-07",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA11089900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West New York, NJ

Sources for this page

Verify at the official NPI Registry.