Taryn Jane Deantonio, CRNP
Individual provider Active NPI Family Nurse Practitioner · Hughesville, PA
NPI 1003375569 · NPPES record last updated Apr 14, 2022
Key facts
- NPI
- 1003375569
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- SP020073 (PA)
- Practice address
- 246 S Main St
Hughesville, PA 17737-1614 - Phone
- (570) 584-5144
- Fax
- (570) 584-5416
- NPI assigned
- Mar 14, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Family Practice Center PC
Practice addresses (Care Compare)
246 S Main St
Hughesville, PA 17737-1614
Phone (570) 584-5144
Hospital & facility affiliations
- Upmc Williamsport
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190424002618 | PA | Practitioner - Nurse Practitioner | 6608118500 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN632596 | PA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Practice Center, PC | Current |
Accepting new patients | |
| Family Practice Center, PC | Multi-Specialty | Current |
Accepting new patients |
| Lycoming Physician Services,Inc. | Multi-Specialty | Past | Accepting new patients |
Locations
246 S Main St
Hughesville, PA 17737
Phone (570) 584-5144
7 Dock Hill Rd
Middleburg, PA 17842
Phone (570) 837-2123
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse |
163W00000X | RN632596 | PA | |
| Family Nurse Practitioner |
363LF0000X | SP020073 | PA | Yes |
Addresses
Primary practice location
246 S Main St
Hughesville, PA 17737-1614
Mailing address
7 Dock Hill Rd
Middleburg, PA 17842-8910
Phone (570) 837-2123
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 789203 | Other | PA | MEDICARE |
| 1036187200001 | Medicaid | PA |
Other names
- Taryn Jane Buono
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | taryndeantoniocrnp@fpc.medentdirect.com | Health Information Exchange (HIE) | FAMILY PRACTICE CENTER, PC |
Other providers in Hughesville, PA
- Melissa Barto
- Heather Bellum
- Care Givers America Home Health Services
- Nancy Elizabeth Dailey
- Melissa Davis
- Brianna Marie Dority
- Christine Elizabeth Doty
- Tracy Dreibleibs
- Brian Duke
- Megan Earnest
All providers in Hughesville, PA · Family Nurse Practitioner in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.