Individual provider Active NPI

Taryn Jane Deantonio, CRNP

  • Family Nurse Practitioner
  • Hughesville, PA
National Provider Identifier
1003375569
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP020073 Issued in PA
Practice address
246 S Main St
Hughesville, PA 17737-1614
Phone
(570) 584-5144
Fax
(570) 584-5416
NPI assigned
Mar 14, 2019
Last updated
Apr 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X RN632596 PA
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X SP020073 PA Primary

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 names 1

  • Taryn Jane Buono Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address taryndeantoniocrnp@fpc.medentdirect.com Health Information Exchange (HIE) FAMILY PRACTICE CENTER, PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190424002618 PA Practitioner - Nurse Practitioner 6608118500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Practice Center PCGroup PAC ID 0244124212, 351 clinicians

Practice addresses (Care Compare)

246 S Main St
Hughesville, PA 17737-1614
Phone (570) 584-5144

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN632596PAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice Center, PC CurrentSince Apr 1, 2019 Accepting new patients
Family Practice Center, PC Multi-Specialty CurrentSince Apr 1, 2019 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

Interoperability endpoints

  • Direct secure messaging: taryndeantoniocrnp@fpc.medentdirect.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1003375569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 DOCK HILL RD",
            "city": "MIDDLEBURG",
            "state": "PA",
            "postal_code": "178428910",
            "telephone_number": "570-837-2123",
            "fax_number": "570-837-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 S MAIN ST",
            "city": "HUGHESVILLE",
            "state": "PA",
            "postal_code": "177371614",
            "telephone_number": "570-584-5144",
            "fax_number": "570-584-5416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANTONIO",
        "first_name": "TARYN",
        "middle_name": "JANE",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-14",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN632596",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP020073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "taryndeantoniocrnp@fpc.medentdirect.com",
            "affiliation": "Y",
            "affiliationName": "FAMILY PRACTICE CENTER, PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "246 S Main St",
            "city": "Hughesville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "177371614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TARYN",
            "last_name": "BUONO",
            "middle_name": "JANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hughesville, PA

Sources for this page

Verify at the official NPI Registry.