Individual provider Active NPI

Maurice Tayag

  • Adult Health Nurse Practitioner
  • Astoria, NY
National Provider Identifier
1710852025
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
898058 Issued in NY
Practice address
1115 Broadway Apt 5J
Astoria, NY 11106-4886
Phone
(689) 345-4552
Fax
(689) 345-4552
NPI assigned
Oct 7, 2025
Last updated
Oct 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 898058 NY Primary

Addresses

Primary practice location

1115 Broadway Apt 5J
Astoria, NY 11106-4886

Mailing address

1115 Broadway Apt 5J
Astoria, NY 11106-4886
Phone (689) 345-4552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
898058NYMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1759795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1710852025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 BROADWAY APT 5J",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111064886",
            "telephone_number": "689-345-4552",
            "fax_number": "689-345-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 BROADWAY APT 5J",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111064886",
            "telephone_number": "689-345-4552",
            "fax_number": "689-345-4552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYAG",
        "first_name": "MAURICE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-07",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "898058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.