Active NPI
Bridget Elizabeth Tyner Saroya, CPNP
- Pediatric Nurse Practitioner
- Chicago, IL
National Provider Identifier
1144200056
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- RN305998 NP08460
- Practice address
- 1044 N Mozart St
Ste-402
Chicago, IL 60622-2789 - Phone
- (773) 292-4501
- Fax
- (773) 292-2613
- NPI assigned
- Jan 18, 2006
- Last updated
- Jun 29, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | RN305998 NP08460 | OH | Primary |
| Pediatric Nurse Practitioner | 363LP0200X | 209013607 | IL |
Addresses
Primary practice location
1044 N Mozart St
Ste-402
Chicago, IL 60622-2789
Mailing address
1044 N Mozart St
Ste-402
Chicago, IL 60622-2789
Phone (773) 292-4501
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2611598 | Medicaid | OH |
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
- Certified Pediatric Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209013607 | IL | MD | Pediatric Nurse Practitioner |
| RN305998 NP08460 | OH | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McNairy County Schools | Past | Accepting new patients | |
| Cumberland County Board of Education | Past | Accepting new patients | |
| Grace Pediatrics PLLC | Pediatrics | Past | Accepting new patients |
| Lebanon Special School District | Past | Accepting new patients | |
| Sumner County Board of Education | Past | Accepting new patients | |
| Grace Pediatrics PLLC | Past | Accepting new patients |
Interoperability endpoints
- bridget.saroya.1@31800.direct.athenahealth.com
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.
-
- Local Education Agency (LEA)
- Crossville, TN
- NPI 1427300995
-
- Pediatrics Physician
- Smyrna, TN
- NPI 1467781690
-
- Pediatrics Physician
- Pleasant View, TN
- NPI 1992553689
-
- Speech-Language Pathologist
- Lebanon, TN
- NPI 1497039374
-
- Local Education Agency (LEA)
- Selmer, TN
- NPI 1285922963
-
- Local Education Agency (LEA)
- Gallatin, TN
- NPI 1912266206
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467158400000",
"number": "1144200056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1044 N MOZART ST",
"address_2": "STE-402",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606222789",
"telephone_number": "773-292-4501",
"fax_number": "773-292-2613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1044 N MOZART ST",
"address_2": "STE-402",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606222789",
"telephone_number": "773-292-4501",
"fax_number": "773-292-2613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAROYA",
"first_name": "BRIDGET",
"middle_name": "ELIZABETH TYNER",
"credential": "CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-18",
"last_updated": "2016-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "OH",
"license": "RN305998 NP08460",
"primary": true
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "IL",
"license": "209013607",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2611598",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.