Individual provider Active NPI

Ruth Ayukonsoh Tanyi, RN, MSN, NP-C

  • Family Nurse Practitioner
  • San Bernardino, CA
National Provider Identifier
1053463612
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
15272 Issued in CA
Practice address
577 N D St
Suite # 101
San Bernardino, CA 92401-1324
Phone
(909) 386-1500
Fax
(909) 386-1588
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 15272 CA Primary

Addresses

Primary practice location

577 N D St
Suite # 101
San Bernardino, CA 92401-1324

Mailing address

577 N D St
Suite # 101
San Bernardino, CA 92401-1324
Phone (909) 386-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050421000657 CA Practitioner - Nurse Practitioner 5193763936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

577 N D St
Suite 101
San Bernardino, CA 92401-1326
Phone (909) 386-1500

Hospital & facility affiliations

  • Destiny Home Health Agency, Inc Home health agency, Moreno Valley, CA, CCN 058263
  • All in One Home Health Agency Inc Home health agency, San Bernardino, CA, CCN 059478

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
15272CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Ruth Tanyi, Inc Family CurrentSince Jul 13, 2010 Accepting new patients

Locations

577 N D St
Ste 101
Sn Bernrdno, CA 92401
Phone (909) 386-1500

Organizations & group practices 1

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

Hospital & facility affiliations 2

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279670400000",
    "number": "1053463612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 N D ST",
            "address_2": "SUITE # 101",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011324",
            "telephone_number": "909-386-1500",
            "fax_number": "909-386-1588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 N D ST",
            "address_2": "SUITE # 101",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011324",
            "telephone_number": "909-386-1500",
            "fax_number": "909-386-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANYI",
        "first_name": "RUTH",
        "middle_name": "AYUKONSOH",
        "name_prefix": "Dr.",
        "credential": "RN, MSN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2010-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "15272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.