Individual provider Active NPI

Talia Bardash

  • Physician Assistant
  • New Square, NY
National Provider Identifier
1861136145
Registry record updated Apr 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
028280 Issued in NY
Practice address
728 N Main St
New Square, NY 10977-8916
Phone
(845) 354-9300
NPI assigned
Apr 23, 2022
Last updated
Apr 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2022

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 028280 NY Primary
Physician Assistant 363A00000X 25MP00701000 NJ

Addresses

Primary practice location

728 N Main St
New Square, NY 10977-8916

Mailing address

786 Washburn St
Teaneck, NJ 07666-2243
Phone (201) 446-5507

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220601001102 NY Practitioner - Physician Assistant 9133507296 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00701000NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Refuah Health Center Inc CurrentSince May 23, 2022 Accepting new patients
Refuah Health Center, Inc. CurrentSince May 23, 2022 Accepting new patients
RX Consultant Pharmacy Inc Past Accepting new patients
Refuah Health Center, Inc. Past Accepting new patients

Locations

728 N Main St
New Square, NY 10977
Phone (845) 354-9301

728 N Main St
Ste C
New Square, NY 10977
Phone 84535493001826

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1650672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650672000000",
    "number": "1861136145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "786 WASHBURN ST",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076662243",
            "telephone_number": "201-446-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 N MAIN ST",
            "city": "NEW SQUARE",
            "state": "NY",
            "postal_code": "109778916",
            "telephone_number": "845-354-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARDASH",
        "first_name": "TALIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-23",
        "last_updated": "2022-04-23",
        "certification_date": "2022-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "028280",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00701000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Square, NY

Sources for this page

Verify at the official NPI Registry.