Individual provider Active NPI

Tamikio P Anderson, FNP

  • Family Nurse Practitioner
  • Media, PA
National Provider Identifier
1104546068
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP026222 Issued in PA
Practice address
2 W Baltimore Ave Ste 101
Media, PA 19063-3740
Phone
(484) 227-0900
Fax
(484) 227-2132
NPI assigned
Aug 31, 2022
Last updated
Jan 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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 SP026222 PA
Family Nurse Practitioner 363LF0000X SP026222 PA Primary

Addresses

Primary practice location

2 W Baltimore Ave Ste 101
Media, PA 19063-3740

Mailing address

3803 W Chester Pike Ste 160
Newtown Square, PA 19073-2336
Phone (484) 227-0900

Other practice location 1

3401 N Broad St
Philadelphia, PA 19140-5189
Phone (267) 269-5705

Other identifiers 1

IdentifierTypeStateIssuer
SP026222OtherPACRNP LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Tamikio.anderson@tuhs.temple.edu Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20231026001061 PA Practitioner - Nurse Practitioner 2860848991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

2 W Baltimore Ave
Media, PA 19063-3740
Phone (484) 227-0900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP026222PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Multi-Specialty CurrentSince Oct 25, 2025 Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

2 W Baltimore Ave
Media, PA 19063
Phone (484) 227-0900

2 W Baltimore Ave
Ste 101
Media, PA 19063
Phone (484) 227-0900

3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1104546068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 W CHESTER PIKE STE 160",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190732336",
            "telephone_number": "484-227-0900",
            "fax_number": "484-227-2132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 W BALTIMORE AVE STE 101",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633740",
            "telephone_number": "484-227-0900",
            "fax_number": "484-227-2132"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191405189",
            "country_code": "US",
            "telephone_number": "267-269-5705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "TAMIKIO",
        "middle_name": "P",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP026222",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP026222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNP LICENSE",
            "identifier": "SP026222",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Tamikio.anderson@tuhs.temple.edu",
            "affiliation": "N",
            "endpointDescription": "Tamikio.anderson@tuhs.temple.edu",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "2672695705",
            "address_1": "3401 N Broad St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191405189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.