Lusine Tatevosyan, PA
NPI 1629169768ActiveIndividual· Physician Assistant· Teaneck, NJ
Physician Assistant (PA) with Excelcare Medical Associates PA, practicing in Teaneck, New Jersey. 23 Medicare patients in 2024, $4,550 paid; nearly all of their 57 Part D prescriptions were generic (95%). Lists Holy Name Medical Center as a hospital affiliation.
Overview
| NPI | 1629169768 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA |
| Sole proprietor | No |
| NPI issued | Sep 27, 2006 |
| Last updated in NPPES | Apr 3, 2025 |
| Certified by provider | Apr 3, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 25MP00165700 | NJ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (NJ) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 23 |
|---|---|
| Services billed | 54 across 12 procedure codes |
| Paid by Medicare | $4,550 |
Part D prescriptions in 2024
| Prescriptions (claims) | 57 · 63 30-day fills |
|---|---|
| Patients | 25 |
| Total drug cost | $933.55 |
| Generic share | 95% of claims |
Education and affiliations
| Graduation year | 2006 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Excelcare Medical Associates PAFairview, NJ · 205 clinicians
Hospital affiliation
- Holy Name Medical CenterTeaneck, NJ
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
Other physician assistants in Teaneck
- 1003879347
- 1205021060
- 1316389224
- 1346516408
- 1407522675
- 1477758225
- 1518643535
- 1588746721
- 1710765086
- 1760593156
- 1760937866
- 1770100646
All 42 physician assistants in Teaneck · All physician assistants in New Jersey