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

MS. Lusine Tatevosyan, PA

Individual provider Physician Assistant · NPI 1629169768

MS. Lusine Tatevosyan, PA is a Physician Assistant in Teaneck, New Jersey. Qualified in 2006, 20 years ago. Practices with Excelcare Medical Associates PA, a 199-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
20
Licensed in
NJ
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

718 Teaneck Rd
Teaneck, NJ 07666-4245
Phone: (201) 833-3000
Fax: (201) 227-6207
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 25MP00165700 (NJ)

Record details

NPI number1629169768
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 27, 2006
Last updated in NPPESApril 3, 2025
Certification dateApril 3, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Excelcare Medical Associates Pa — 199 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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