Bruce Tisch, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

MA31321 Issued in NJ

Practice address

177 N Dean St
Suite 208
Englewood, NJ 07631-2533

Phone

(201) 569-0200

Fax

(201) 569-8287

NPI assigned

Aug 4, 2006

Last updated

Apr 28, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Englewood Surgical Services, LLC

  • Obstetrics & Gynecology Physician
  • Englewood, NJ
  • NPI 1437282464
  Medicare reassignment NPD
• OB-GYN Associates of Englewood,PA

  • Obstetrics & Gynecology Physician
  • Englewood, NJ
  • NPI 1700894417
  Medicare reassignment NPD
• OBGYN Associates of Englewood

  • Obstetrics & Gynecology Physician
  • Englewood, NJ
  • NPI 1033290432
  Authorized official Same address or phone
• Metropolitan Surgical Associates Inc. Dba Metropolitan Medical Assoc

  • Ambulatory Surgical Clinic/Center
  • Englewood, NJ
  • NPI 1679605729
  NPD (past)

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1932117629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 N DEAN ST",
            "address_2": "SUITE 208",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312533",
            "telephone_number": "201-569-0200",
            "fax_number": "201-569-8287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 N DEAN ST",
            "address_2": "SUITE 208",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312533",
            "telephone_number": "201-569-0200",
            "fax_number": "201-569-8287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISCH",
        "first_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "MA31321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4719301",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suman Thomas
• Brian Daniel Thompson
• Thoracic and Vascular Associates of New Jersey
• Elizabeth Thottumalil Thomas
• Joan D. Timbang, PT
• Danielle Tischer
• Mikhail Tismenetsky, MD
• Priscilla Tixi
• Aileen P. Tlamsa, M.D.
• Tmscoa, LLC (TMS Centers of America)

• Obstetrics & Gynecology Physician in Englewood, NJ
• Providers in Englewood, NJ by specialty
• Obstetrics & Gynecology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.