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SHANE TATAR PA
NPI 1770932303
Physician Assistant - Medical in Merrick, NY

Active since June 04, 2016PECOS Enrolled
389 MERRICK AVE, MERRICK, NY 11566(516) 867-5132(516) 867-5519 Get Directions Write a Review

NPPES record last updated: May 23, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Shane Tatar Pa NPPES

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

SHANE TATAR PA (NPI 1770932303) is an individual medical provider in Merrick, New York, licensed in New York (019324) and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1770932303
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameSHANE TATARCredential: PA
Location Address389 MERRICK AVEMerrick, NY 11566-2723
Mailing Address221 Broadway, 207Amityville, NY 11701-2780 · (631) 598-0009 · Fax (631) 598-0099
Phone(516) 867-5132
Fax(516) 867-5519
Sole ProprietorNo
Enumeration DateJune 4, 2016
Last NPPES UpdateMay 23, 2023
NPPES CertifiedMay 23, 2023
✔ NPI 1770932303 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in NY · 019324
389 MERRICK AVE, Merrick, NY 11566
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shane Tatar Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 11

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

FRANCHESKA NIVEYRO
Counselor (Mental Health)
389 MERRICK AVE
MERRICK, NY 11566
Nassau County (516) 247-6449
GABRIELLE JOSEPH MS, LMHC.
Counselor (Mental Health)
389 MERRICK AVE
MERRICK, NY 11566
Nassau County (516) 247-6449
HINAL V PATEL PT
Physical Therapist (Orthopedic)
389 MERRICK AVE
NORTH MERRICK, NY 11566
Nassau County (830) 243-2352
SHANNON MARIE BUDGELL LMHC
Counselor (Mental Health)
389 MERRICK AVE
MERRICK, NY 11566
Nassau County (515) 247-6449
MARISSA S SYDIAL PA-C
Physician Assistant
389 MERRICK AVE
MERRICK, NY 11566
Nassau County (516) 867-5132
LAUREN IRENE KILDARE
Counselor (Mental Health)
389 MERRICK AVE
MERRICK, NY 11566
Nassau County (516) 247-6449
MS. ALEXANDRIA E CIULLA LMHC
Counselor (Mental Health)
389 MERRICK AVE
MERRICK, NY 11566
Nassau County (516) 247-6449
MISS DARLENE MARIA SANCHEZ FNP
Nurse Practitioner (Family)
389 MERRICK AVE
MERRICK, NY 11566
Nassau County (516) 867-5132

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 Shane Tatar's NPI number?

The NPI number for Shane Tatar is 1770932303. It was assigned to this individual provider in the NPPES registry on June 4, 2016.

Where is Shane Tatar located?

Shane Tatar practices at 389 Merrick Ave, Merrick, NY 11566. The listed phone number is (516) 867-5132.

What is Shane Tatar's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Shane Tatar enrolled in Medicare?

Yes. Shane Tatar is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shane Tatar was last updated on May 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.