Individual provider Active NPI

Bridget Elizabeth Tyner Saroya, CPNP

  • Pediatric Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1144200056
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN305998 NP08460 Issued in OH
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, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2611598MedicaidOH

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

LicenseStateTypeSpecialty
209013607ILMDPediatric Nurse Practitioner
RN305998 NP08460OHMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew 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 PastSince May 12, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.