Tanja Nazzal Wysocki, FNP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11030456 Issued in FL

Practice address

2000 Fowler Grove Blvd
Winter Garden, FL 34787-5050

Phone

(407) 368-9527

NPI assigned

Jan 4, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• American Current Care PA

  • Urgent Care Clinic/Center
  • Pinecrest, FL
  • NPI 1770719296
  Medicare reassignment

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

{
    "created_epoch": "1704326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1144090713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 FOWLER GROVE BLVD",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347875050",
            "telephone_number": "407-368-9527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 FOWLER GROVE BLVD",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347875050",
            "telephone_number": "407-368-9527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYSOCKI",
        "first_name": "TANJA",
        "middle_name": "NAZZAL",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-04",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "11030456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janice Louise Wooten, OTR
• Desiree Wootson
• Darren Wright I
• Jeremy Shakouri Wydra
• Angelica Maria Wyman, DNP, AGACNP
• Matthew B Yampolsky, MS, ATC, LAT
• Adriana Yates Munar, MD
• Daniel Yee, PHARMD
• Dereje Yideg
• Mazen Zaarour, M.D.

• Family Medicine Physician in Winter Garden, FL
• Providers in Winter Garden, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.