Tynetta Sharon Eleazer, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ00767600 Issued in NJ

Practice address

230 E Ridgewood Ave
Paramus, NJ 07652-4142

Phone

(201) 597-4130

NPI assigned

Oct 27, 2017

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 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

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bergen County Improvement AuthorityGroup PAC ID 9032104047, 95 clinicians

Jersey Irish MedicalGroup PAC ID 0941451215, 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Bergen County Improvement Authority

  • Internal Medicine Physician
  • Paramus, NJ
  • NPI 1891836441
  Medicare reassignment Care Compare group NPD
• Jersey Irish Medical

  • Urgent Care Clinic/Center
  • Bound Brook, NJ
  • NPI 1144575739
  Medicare reassignment Care Compare group NPD
• One Bergen Health PC

  • Internal Medicine Physician
  • Bergenfield, NJ
  • NPI 1508753492
  Medicare reassignment
• Bergen County Improvement Authority

  • Psychiatric Hospital Unit
  • Paramus, NJ
  • NPI 1952456295
  NPD

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

{
    "created_epoch": "1509062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1922510148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 E RIDGEWOOD AVE",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076524142",
            "telephone_number": "201-597-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E RIDGEWOOD AVE",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076524142",
            "telephone_number": "201-597-4130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 W Union Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Bound Brook",
            "state": "NJ",
            "postal_code": "088051166",
            "country_code": "US",
            "telephone_number": "732-469-3627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELEAZER",
        "first_name": "TYNETTA",
        "middle_name": "SHARON",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-27",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00767600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Paramus, NJ
• Providers in Paramus, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.