Individual provider Active NPI

Tamara Loy

  • Pediatric Nurse Practitioner
  • Troy, MI
National Provider Identifier
1053739706
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
95000071 Issued in CA
Practice address
44201 Dequindre Rd
Beaumont Emergency Services
Troy, MI 48085-1117
Phone
(248) 964-5111
Fax
(248) 964-5068
NPI assigned
Mar 31, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704301265 MI
Pediatric Nurse Practitioner 363LP0200X 95000071 CA Primary

Addresses

Primary practice location

44201 Dequindre Rd
Beaumont Emergency Services
Troy, MI 48085-1117

Mailing address

152 Pioneer LN
Ste H
Bishop, CA 93514-2563
Phone (248) 577-3511

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
I20191106002937 CA Practitioner - Nurse Practitioner 9830312115 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95000071CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Inyo Healthcare District CurrentSince Sep 1, 2019 Accepting new patients
Northern Inyo Healthcare District Current Accepting new patients
Northern Inyo Associates CurrentSince Sep 1, 2019 Accepting new patients

Locations

152 Pioneer Ln
Ste H
Bishop, CA 93514
Phone (760) 873-6373

150 Pioneer Ln
Bishop, CA 93514
Phone (760) 873-2136

301 N Fowler St
Bishop, CA 93514
Phone (760) 872-3680

152 Pioneer Ln
Ste F
Bishop, CA 93514
Phone (760) 872-1606

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1053739706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 PIONEER LN",
            "address_2": "STE H",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935142563",
            "telephone_number": "248-577-3511",
            "fax_number": "248-577-3526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44201 DEQUINDRE RD",
            "address_2": "BEAUMONT EMERGENCY SERVICES",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480851117",
            "telephone_number": "248-964-5111",
            "fax_number": "248-964-5068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOY",
        "first_name": "TAMARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-31",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704301265",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95000071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.