Individual provider Active NPI

Tanairi Vildoso, NP

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1053867838
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F341636-1 Issued in NY
Practice address
5 E 98TH St FL 3
New York, NY 10029-6501
Phone
(212) 824-2350
NPI assigned
Aug 31, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 660507 NY
Family Nurse Practitioner 363LF0000X F341636-1 NY Primary

Addresses

Primary practice location

5 E 98TH St FL 3
New York, NY 10029-6501

Mailing address

245 15B 76 Ave
Bellorose, NY 11426
Phone (347) 336-0606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190219003105 NY Practitioner - Nurse Practitioner 2860730751 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
660507NYMDRegistered Nurse
F341636-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Mar 26, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Mar 26, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

5 E 98th St
#3
New York, NY 10029

5 E 98th St
Fl 3
New York, NY 10029
Phone (212) 241-5170

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

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": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1053867838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 15B 76 AVE",
            "city": "BELLOROSE",
            "state": "NY",
            "postal_code": "11426",
            "telephone_number": "347-336-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 E 98TH ST FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296501",
            "telephone_number": "212-824-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILDOSO",
        "first_name": "TANAIRI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-31",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "660507",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F341636-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.