Individual provider Active NPI

Jay Malvin Reyes Tia

  • Student in an Organized Health Care Education/Training Program
  • New York, NY
National Provider Identifier
1942817317
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1901 1St Ave
New York, NY 10029-7491
Phone
(212) 423-6262
NPI assigned
Sep 29, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1901 1St Ave
New York, NY 10029-7491

Mailing address

1798 3Rd Ave Apt 3B
New York, NY 10029-6196
Phone (415) 271-3409

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240215004284 MD Practitioner - Internal Medicine 4688018849 Reassigns benefits to 1 organization
I20250409000232 NY Practitioner - Internal Medicine 4688018849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jan 30, 2025 Accepting new patients
Montefiore Medical Center CurrentSince Jan 30, 2025 Accepting new patients
Baltimore Medical System, Inc. CurrentSince Dec 26, 2023 Accepting new patients
Baltimore Medical System, Inc. CurrentSince Dec 26, 2023 Accepting new patients

Locations

1000 Stewart Ave
Glen Burnie, MD 21061

111 E 210th St
Bronx, NY 10467

100 Corporate Dr
Ste 100
Yonkers, NY 10701
Phone (914) 378-6148

Networks

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

Interoperability endpoints

  • Direct secure messaging: jaymalvin.tia.p1@direct.bmsi.nextgenshare.com
  • Direct secure messaging: jtia@montefioredirect.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1942817317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1798 3RD AVE APT 3B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296196",
            "telephone_number": "415-271-3409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100297491",
            "telephone_number": "212-423-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIA",
        "first_name": "JAY MALVIN",
        "middle_name": "REYES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-29",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.