Tijuana Temple, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

348067 Issued in NY

Practice address

65 Pennaquid Rd
Coram, NY 11727-1227

Phone

(631) 605-1783

NPI assigned

Aug 16, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Positive Change Psychiatry PLLCGroup PAC ID 7517285455, 6 clinicians

Michael Bishai MD, LLCGroup PAC ID 1153693254, 9 clinicians

Robert Courgi LLCGroup PAC ID 4385023761, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Cost

67.37

Merit-based Incentive Payment System (MIPS)

Final score

92.71 of 100Reported as group

Quality

79.66

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

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

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.

• Michael Bishai MD, LLC

  • Internal Medicine Physician
  • Smithtown, NY
  • NPI 1730609827
  Medicare reassignment Care Compare group NPD
• Positive Change Psychiatry PLLC

  • Psychiatry Physician
  • Syosset, NY
  • NPI 1265821953
  Medicare reassignment Care Compare group NPD
• Robert Courgi LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Woodbury, NY
  • NPI 1174269039
  Medicare reassignment Care Compare group NPD
• T Temple Family Health NP PLLC

  • Family Nurse Practitioner
  • Valley Stream, NY
  • NPI 1912643487
  Medicare reassignment NPD Authorized official
• Fulton Medical, P.C.

  • Internal Medicine Physician
  • Massapequa, NY
  • NPI 1841635133
  Medicare reassignment NPD
• VJJ Holding Company, LLC

  • Skilled Nursing Facility
  • Port Jefferson Station, NY
  • NPI 1780973347
  NPD (past)

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1881369486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 PENNAQUID RD",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117271227",
            "telephone_number": "631-605-1783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 PENNAQUID RD",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117271227",
            "telephone_number": "631-605-1783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEMPLE",
        "first_name": "TIJUANA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "348067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Tableman, PMHNP
• Emmett Tabor
• Jazeb T Tariq, MD
• Ashley Elizabeth Teague, L.AC
• Cynthia Ann Teixeira, PHD, LCSW
• Heather Marie Testa, LPN
• Thao Nguyen Nurse Practitioner in Psychiatry PC
• Damon Jessie Thomas, RN
• Francesca Thomas
• Shara Ronniese Thomas, NURSE

• Family Nurse Practitioner in Coram, NY
• Providers in Coram, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; 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.