Tara Nizamov, PHYSICIAN ASSISTANT
NPI 1558179093 · Physician Assistant · Mount Vernon, NY
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Tara Nizamov, PHYSICIAN ASSISTANT is a Physician Assistant provider in Mount Vernon, NY (NPI 1558179093).
Provider details
- NPI number
- 1558179093
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PHYSICIAN ASSISTANT
- Sex
- Female
- Sole proprietor
- No
- License
- 032848 (NY)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2024-12-30
- Last updated
- 2025-06-08
- Certified
- 2025-06-08
Frequently asked questions
- What is Tara Nizamov's NPI number?
- Tara Nizamov's National Provider Identifier (NPI) is 1558179093, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Tara Nizamov's specialty?
- Tara Nizamov is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Tara Nizamov located?
- Tara Nizamov's practice location on file with NPPES is 12 N 7th Ave, Mount Vernon, NY 10550-2026.
- What is Tara Nizamov's phone number?
- The practice phone number listed in the NPPES registry for Tara Nizamov is (917) 557-9895.
- Does Tara Nizamov accept Medicare?
- Tara Nizamov is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Tara Nizamov's NPI active?
- Yes — Tara Nizamov's NPI (1558179093) is active in the NPPES registry as of the last update on 2025-06-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.