NPIMap

Individual provider Active NPI

Tanya Monique Bronzell-Wynder, DNP, CRNP

  • Family Nurse Practitioner
  • Camden, NJ
National Provider Identifier
1013913797
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00600900 Issued in NJ
Practice address
433 N 7TH St FL 1
Camden, NJ 08102-2212
Phone
(856) 288-9115
Fax
(856) 379-4286
NPI assigned
Jun 27, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP013200 PA
Adult Health Nurse Practitioner 363LA2200X SP008348 PA
Family Nurse Practitioner 363LF0000X 26NJ00600900 NJ Primary

Addresses

Primary practice location

433 N 7TH St FL 1
Camden, NJ 08102-2212

Mailing address

2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Phone (215) 707-5864

Other practice location 1

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-5864

Other identifiers 1

IdentifierTypeStateIssuer
102679121MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050314000926 PA Practitioner - Nurse Practitioner 1951356880 Reassigns benefits to 2 organizations
I20161017000239 NJ Practitioner - Nurse Practitioner 1951356880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-3008

433 N 7TH St
FL 1
Camden, NJ 08102-2212
Phone (856) 288-9115

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP013200PAMDAcute Care Nurse Practitioner
SP008348PAMDAdult Health Nurse Practitioner
26NJ00600900NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc CurrentSince Mar 6, 2019 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Mar 6, 2019 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Lifecycles Health Services Inc Family CurrentSince Aug 7, 2016 Accepting new patients
Jefferson University Physicians CurrentSince Oct 6, 2015 Accepting new patients
The Cooper Health System Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Virtua Our Lady of Lourdes Hospital Inc Past Accepting new patients

Locations

2450 W Hunting Park Ave
Philadelphia, PA 19129
Phone (215) 707-2433

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

1100 Walnut St
Ste 500
Philadelphia, PA 19107
Phone (215) 955-6750

8815 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8145

111 S 11th St
Philadelphia, PA 19107
Phone (215) 955-6161

1100 Walnut St
Fl 5
Philadelphia, PA 19107
Phone (215) 955-6750

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 8

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 10

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": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1013913797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-707-5864",
            "fax_number": "215-707-6867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 N 7TH ST FL 1",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081022212",
            "telephone_number": "856-288-9115",
            "fax_number": "856-379-4286"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191405103",
            "country_code": "US",
            "telephone_number": "215-707-5864",
            "fax_number": "215-707-6867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRONZELL-WYNDER",
        "first_name": "TANYA",
        "middle_name": "MONIQUE",
        "name_prefix": "Dr.",
        "credential": "DNP, CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-27",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP013200",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP008348",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00600900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102679121",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.