Individual provider Active NPI

Tanya Lynn Malek, APNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Oconto, WI
National Provider Identifier
1063801975
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11134-33 Issued in WI
Practice address
820 Arbutus Ave
Oconto, WI 54153-2004
Phone
(920) 834-8833
Fax
(920) 834-8830
NPI assigned
Jan 15, 2015
Last updated
Aug 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11134-33 WI Primary

Addresses

Primary practice location

820 Arbutus Ave
Oconto, WI 54153-2004

Mailing address

PO Box 22040
Green Bay, WI 54305-2040
Phone (920) 445-7210

Other practice location 1

301 E Saint Joseph St
Green Bay, WI 54301-2241
Phone (920) 433-6073

Other identifiers 1

IdentifierTypeStateIssuer
2020131682OtherAMERICAN NURSES CREDENTIALING CENTER

Other names 1

  • Tanya L Comyne Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20210903000694 WI Practitioner - Nurse Practitioner 9638575319 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

820 Arbutus Ave
Oconto, WI 54153-2004
Phone (920) 835-1100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oconto Hospital & Medical Center Inc CurrentSince May 10, 2022 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince May 10, 2022 Accepting new patients
Oconto Hospital & Medical Center Inc Current Accepting new patients
Bellin Psychiatric Center Inc. CurrentSince May 10, 2022 Accepting new patients
SBH-Green Bay LLC CurrentSince Aug 3, 2021 Accepting new patients
Bellin Psychiatric Center Inc Current Accepting new patients

Locations

1351 Ontario Rd
Green Bay, WI 54311
Phone (920) 328-1220

301 Saint Joseph St
Green Bay, WI 54301
Phone (920) 430-3630

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

Interoperability endpoints

  • Direct secure messaging: tmalek323534@direct.thedacare.org
  • Direct secure messaging: tmalek925216@direct.emplifyhealth.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1063801975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22040",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052040",
            "telephone_number": "920-445-7210",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 ARBUTUS AVE",
            "city": "OCONTO",
            "state": "WI",
            "postal_code": "541532004",
            "telephone_number": "920-834-8833",
            "fax_number": "920-834-8830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 E Saint Joseph St",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543012241",
            "country_code": "US",
            "telephone_number": "920-433-6073",
            "fax_number": "920-431-0333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALEK",
        "first_name": "TANYA",
        "middle_name": "LYNN",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-15",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "11134-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN NURSES CREDENTIALING CENTER",
            "identifier": "2020131682",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TANYA",
            "last_name": "COMYNE",
            "middle_name": "L",
            "credential": "APNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oconto, WI

Sources for this page

Verify at the official NPI Registry.