Rebecca Tyson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00310800 Issued in NJ

Practice address

111 Central Ave
Newark, NJ 07102-1909

Phone

(973) 877-5500

NPI assigned

Jun 28, 2013

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

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Medical Group of New JerseyGroup PAC ID 4082979166, 299 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• The Radiology Group of New Jersey, LLC

  • Multi-Specialty Clinic/Center
  • Hackettstown, NJ
  • NPI 1174010540
  Medicare reassignment Care Compare group
• DRX Paramus, LLC

  • Urgent Care Clinic/Center
  • Paramus, NJ
  • NPI 1316272685
  Medicare reassignment
• Golding Granado Medical Associates

  • Internal Medicine Physician
  • Shrewsbury, NJ
  • NPI 1427243443
  Medicare reassignment
• Immediate Care Medical Walk-in of Hazlet, PA

  • Urgent Care Clinic/Center
  • Hazlet, NJ
  • NPI 1245595313
  Medicare reassignment
• Middlesex Emergency Physicians, P.a.

  • Emergency Medicine Physician
  • Edison, NJ
  • NPI 1811921760
  Medicare reassignment
• Nes Georgia Inc

  • Emergency Medicine Physician
  • Elizabeth, NJ
  • NPI 1043616675
  Medicare reassignment
• Urgent Care Physicians of New Jersey, LLC

  • Emergency Medicine Physician
  • Red Bank, NJ
  • NPI 1447622402
  Medicare reassignment
• Nes Georgia Inc

  • Emergency Medicine Physician
  • Newark, NJ
  • NPI 1912411331
  NPD
• Essex Emergency Group PC

  • Emergency Medicine Physician
  • Newark, NJ
  • NPI 1548531643

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1932549490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CENTRAL AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CENTRAL AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021909",
            "telephone_number": "973-877-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSON",
        "first_name": "REBECCA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-28",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00310800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0469718",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Naveen Tyagi, M.D.
• Peter Tylawsky
• Horace Tyler Jr., LCADC CCS
• Siah Grace Tyler, APN
• Leslie Tyrie, M.D.
• Brooke Tyszkiewicz, MPAS, PA-C
• Jocelynda O Udasco, MD
• Kathy Arlene Udell-Martin, D.D.S.
• Tamar Udkow, PHARMD
• Victor Uduaghan, M.D.

• 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 May 1, 2023; 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.