CRYSTAL TANK M.D.
NPI 1043639453
Internal Medicine in Glen Ridge, NJ

Q: What is Crystal Tank's NPI number?

The NPI number for Crystal Tank is 1043639453. It was assigned to this individual provider in the NPPES registry on April 14, 2014.

Q: What is Crystal Tank's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Crystal Tank was last updated on February 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 14, 2014PECOS EnrolledAccepts Medicare Assignment

311 BAY AVE, MMG INTERNAL MED, GLEN RIDGE, NJ 07028(973) 748-9246(973) 748-8755 Get Directions Write a Review

NPPES record last updated: February 17, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 17, 2020, Feb 14, 2020, Sep 18, 2018 (3 updates tracked since 2018).

On this page

About Crystal Tank M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CRYSTAL TANK M.D. (NPI 1043639453) is an individual internal medicine provider in Glen Ridge, New Jersey, licensed in New Jersey (25MA10421000) and active in the NPI registry since April 2014. She is enrolled in Medicare PECOS, is affiliated with Hackensack Meridian Health, Mountainside Medical, and is a graduate of State University Of New York At Stony Brook, School Of Medicine (2014).

NPPES Registry Identity

NPI1043639453

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameCRYSTAL TANKCredential: M.D.

Location Address311 BAY AVE, MMG INTERNAL MEDGlen Ridge, NJ 07028

Mailing AddressPo Box 419430Boston, MA 02241-9430 · (201) 967-8221 · Fax (201) 483-2242

Phone(973) 748-9246

Fax(973) 748-8755

Sole ProprietorNo

Medical School CMSState University Of New York At Stony Brook, School Of MedicineGraduated 2014

Enumeration DateApril 14, 2014

Last NPPES UpdateFebruary 17, 20203 updates tracked since enumeration

✔ NPI 1043639453 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in NJ · 25MA10421000

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

311 BAY AVE, Glen Ridge, NJ 07028

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Crystal Tank M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2163766312

PECOS Enrollment IDI20181129001466

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Crystal Tank reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mpv New Jersey MD Services PC

15 mi

General Practice

250 OLD HOOK RD
Westwood, NJ 07675

Reassigned Medicare billing, New Jersey enrollment
189 clinicians in this Medicare group

NPI 1215391271 (201) 781-1387

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

241 services112 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

91 services60 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

81 services81 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

56 services55 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

52 services50 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

16 services16 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

16 services13 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

16 services16 patients

Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg J3420

This is a procedure where a small dose of Vitamin B-12, also known as Cyanocobalamin, is injected into your body. This vitamin is essential for nerve function and the production of red blood cells. It's often used to treat vitamin B-12 deficiency.

16 services13 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

14 services14 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

12 services12 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Hackensack Meridian Health, Mountainside Medical

Acute Care Hospitals · Montclair, NJ

2/5 CMS rating

OwnershipProprietary

CMS Certification Number310054

Location1 Bay AvenueMontclair, NJ 07042 · Essex County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07028 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$144.86 typical visit price

range $63.84 – $190.92

Typical copayment $36.21 (range $15.96 – $47.73)

Most-billed visit code 99204

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

7 suppliers13 claims27 services$5.71 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KULVIR SINGH NANDRA M.D.

Colon & Rectal Surgery

311 BAY AVE
GLEN RIDGE, NJ 07028

Essex County (973) 798-4777

WARVEEN OTHMAN PA-C

Physician Assistant

311 BAY AVE, STE 202
GLEN RIDGE, NJ 07028

Essex County (848) 308-5366

DR. BARRY J WEBER M.D.

Internal Medicine (Pulmonary Disease)

311 BAY AVE, MMG PULMONOLOGY
GLEN RIDGE, NJ 07028

Essex County (973) 746-7474

DR. MATTHEW COONS MD

Plastic Surgery

311 BAY AVE
GLEN RIDGE, NJ 07028

Essex County (908) 810-8550

SANGBAEK CHARLES OH MD

Internal Medicine (Gastroenterology)

311 BAY AVE, MMG GASTROENTEROLOGY
GLEN RIDGE, NJ 07028

Essex County (973) 748-9166

DR. EFTHYMIOS I DANISKAS M.D.

Internal Medicine (Pulmonary Disease)

311 BAY AVE, MMG PULMONOLOGY
GLEN RIDGE, NJ 07028

Essex County (973) 746-7474

JUHAYNA KASSEM DAVIS MD

Internal Medicine (Pulmonary Disease)

311 BAY AVE, MMG PULMONOLOGY
GLEN RIDGE, NJ 07028

Essex County (973) 433-7034

MS. ANJALI GROVER M.D.

Internal Medicine (Endocrinology, Diabetes & Metabolism)

311 BAY AVE, MMG ENDOCRINOLOGY
GLEN RIDGE, NJ 07028

Essex County (973) 744-3733

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Crystal Tank's NPI number?

The NPI number for Crystal Tank is 1043639453. It was assigned to this individual provider in the NPPES registry on April 14, 2014.

Where is Crystal Tank located?

Crystal Tank practices at 311 Bay Ave Mmg Internal Med, Glen Ridge, NJ 07028. The listed phone number is (973) 748-9246.

What is Crystal Tank's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Crystal Tank enrolled in Medicare?

Yes. Crystal Tank is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Crystal Tank's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Crystal Tank reassigns Medicare benefits to Mpv New Jersey MD Services PC (Westwood, NJ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Crystal Tank's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Crystal Tank accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Oscar Health list Crystal Tank as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Crystal Tank affiliated with any hospitals?

According to CMS data, Crystal Tank is affiliated with Hackensack Meridian Health, Mountainside Medical.

When was this NPI record last updated?

The NPPES record for Crystal Tank was last updated on February 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.