Individual provider Active NPI

Tynaesha Felder-Tate

  • In Home Supportive Care Agency
  • Elkins Park, PA
National Provider Identifier
1063122927
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
69503601 Issued in PA
Practice address
7754 Wagner Way Apt B
Elkins Park, PA 19027-1028
Phone
(267) 806-7527
NPI assigned
Dec 1, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
HomemakerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 376J00000X 69503601 PA
Respite Care 385H00000X 69503601 PA
In Home Supportive Care Agency 253Z00000X 69503601 PA Primary

Addresses

Primary practice location

7754 Wagner Way Apt B
Elkins Park, PA 19027-1028

Mailing address

7754 Wagner Way Apt B
Elkins Park, PA 19027-1028
Phone (267) 806-7527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
69503601PAMDIn Home Supportive Care Agency

NPI Registry JSON

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

{
    "created_epoch": "1669852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1063122927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7754 WAGNER WAY APT B",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271028",
            "telephone_number": "267-806-7527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7754 WAGNER WAY APT B",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271028",
            "telephone_number": "267-806-7527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDER-TATE",
        "first_name": "TYNAESHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-01",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376J00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": "PA",
            "license": "69503601",
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "PA",
            "license": "69503601",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "PA",
            "license": "69503601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkins Park, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.