Individual provider Active NPI

Amanda B Tenhulzen, ANP-C

  • Adult Health Nurse Practitioner
  • Albany, NY
National Provider Identifier
1083612147
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F304140 Issued in NY
Practice address
2 Palisades Dr
Albany, NY 12205-1438
Phone
(518) 458-2000
Fax
(518) 458-1524
NPI assigned
Jul 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F304140 NY Primary

Addresses

Primary practice location

2 Palisades Dr
Albany, NY 12205-1438

Mailing address

2 Palisades Dr
Albany, NY 12205-1438
Phone (518) 458-2000

Other identifiers 1

IdentifierTypeStateIssuer
02659483MedicaidNY

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
304140NYMDOphthalmology Physician
F304140NYMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1083612147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PALISADES DR",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051438",
            "telephone_number": "518-458-2000",
            "fax_number": "518-458-1524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PALISADES DR",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051438",
            "telephone_number": "518-458-2000",
            "fax_number": "518-458-1524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENHULZEN",
        "first_name": "AMANDA",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "ANP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F304140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02659483",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; 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.