MS. LUSINE TATEVOSYAN (PA) – Physician Assistant, NPI 1629169768
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,578 PHYSICIAN ASSISTANT in NJ
Provider Addresses for MS. LUSINE TATEVOSYAN (PA)
3 UNIVERSITY PLZ STE 205
HACKENSACK, NJ 076016208
Phone: (201) 833-3599
Fax: (201) 227-6207
Type: Mailing
718 TEANECK RD
TEANECK, NJ 076664245
Phone: (201) 833-3000
Fax: (201) 227-6207
Type: Location
PO BOX 29008
NEWARK, NJ 07101
Phone: (201) 845-9300
Fax: (201) 845-9301
Type: Mailing
10, Forest Avenue, The Outlets at Bergen Town Center, Paramus, Bergen County, New Jersey, 07652, United States
PARAMUS, NJ 07652
Phone: (201) 291-4040
Fax: (201) 291-0404
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2007-01-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20070129000015 | I | Physician Assistant | NJ | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 07601)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | NJ | 27447 | Repair of knee joint | 110 | 109 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | NJ | |
| U R O L O G Y | PA | |
| Nurse Practitioner | NJ | |
| - | NJ | |
| Nurse Practitioner | FL | |
| - | AR | |
| - | NJ | |
| General Surgery | NJ | |
| - | NJ | |
| Nurse Practitioner | NJ |
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