Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Mark Tabaka, PA-C

Individual provider Medical Physician Assistant · NPI 1457353005

Mr. Mark Tabaka, PA-C is a Physician Assistant in Bristol, Connecticut. Qualified in 2005, 21 years ago. Practices with Yale University, a 2,618-clinician group and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
21
Licensed in
CT
In the registry since
2005
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

576 Farmington Ave
Bristol, CT 06010-3933
Phone: (860) 585-3000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 1803 (CT)

Record details

NPI number1457353005
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 12, 2005
Last updated in NPPESNovember 5, 2018
Mailing address11 Arkona Dr, Higganum, CT 06441-4479

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Yale University — 2618 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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