Cristina R Tavarez, MS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00265700 Issued in NJ

Practice address

465 Mount Prospect Ave
Newark, NJ 07104-2907

Phone

(973) 483-3640

Fax

(973) 483-4895

NPI assigned

Sep 1, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prompt MD LLCGroup PAC ID 9739236779, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

State licenses

Practice roles

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.

• Prompt MD LLC

  • Family Medicine Physician
  • Hoboken, NJ
  • NPI 1205073079
  Medicare reassignment Care Compare group
• Adam Alex, LLC

  • Family Medicine Physician
  • Edgewater, NJ
  • NPI 1215346218
  Medicare reassignment
• Am PM Walk in Urgent Care Clinic

  • Urgent Care Clinic/Center
  • Bergenfield, NJ
  • NPI 1073853859
  Medicare reassignment
• Am PM Primary Care

  • Primary Care Clinic/Center
  • Bergenfield, NJ
  • NPI 1083045694
  NPD (past)

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433376000000",
    "number": "1811278906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 MOUNT PROSPECT AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071042907",
            "telephone_number": "973-483-3640",
            "fax_number": "973-483-4895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 MOUNT PROSPECT AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071042907",
            "telephone_number": "973-483-3640",
            "fax_number": "973-483-4895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVAREZ",
        "first_name": "CRISTINA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "MS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-01",
        "last_updated": "2015-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00265700",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00265700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erfan Tasdighi, MD
• Ra'Ad Tashman, M.D.
• Aida Iris Tate
• William Tate
• Kelly Taub, LSW
• Rycelis Tavarez
• Bernice Y Taylor-Jones, LCADC, LPC, CSW, MHS
• Doreen Marion Taylor-Speller, MS, LCADC, CSW
• Ashley Aurelia Taylor, MSN, A-GNP-C,PMHNP
• Bellazmin Natalie Taylor, MS-PA-C

• Physician Assistant in Newark, NJ
• Providers in Newark, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.