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Tara Rose Nizamov, PHYSICIAN ASSISTANT

NPI 1558179093ActiveIndividual· Physician Assistant· Mount Vernon, NY

Physician Assistant (PHYSICIAN ASSISTANT) in Mount Vernon, New York, trained at Mercy College (class of 2024). Enrolled in Medicare as practitioner - physician assistant. Dexcom, Inc. reported $104.63 in payments in 2025, mostly food and beverage.

Overview

NPI1558179093
StatusActive
Entity typeIndividual
CredentialPHYSICIAN ASSISTANT
Sole proprietorNo
NPI issuedDec 30, 2024
Last updated in NPPESJun 8, 2025
Certified by providerJun 8, 2025

Specialties and licenses

TaxonomyCodeLicenseState
Physician Assistant Primary363A00000X032848NY

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Practitioner - Physician Assistant (NY)

Medicare sources and data years

Education and affiliations

Medical schoolMercy College
Graduation year2024
Medicare specialtyPhysician Assistant

Medical group

Hospital affiliations

Source: CMS Care Compare

Industry payments (Open Payments)

  • 2025$104.63 · 3 payments from 1 company

Top paying companies in 2025

CompanyAmountPayments
Dexcom, Inc.$104.633

What the 2025 payments were for

  • Food and Beverage$104.63 · 3 payments

Receiving payments does not imply wrongdoing. What Open Payments covers ·original records

Other Physician Assistant providers in Mount Vernon

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