Individual provider Active NPI

Tanya Magdor, APRN, ANP-C

  • Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1164446571
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP 2208442 Issued in FL
Practice address
880 SW 145TH Ave Ste 202
Pembroke Pines, FL 33027-6171
Phone
(866) 849-0692
Fax
(888) 973-8821
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1123902 TX
Nurse Practitioner 363L00000X ARNP 2208442 FL Primary
Nurse Practitioner 363L00000X 36844 TN
Nurse Practitioner 363L00000X APRN.CNP.0039180 OH
Nurse Practitioner 363L00000X 3-001639 AL

Addresses

Primary practice location

880 SW 145TH Ave Ste 202
Pembroke Pines, FL 33027-6171

Mailing address

PO Box 211699
Eagan, MN 55121-3699
Phone (866) 849-0692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL, TX, TN4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20110112000018 FL Practitioner - Nurse Practitioner 6204905284 Reassigns benefits to 2 organizations
I20240419000121 AL Practitioner - Nurse Practitioner 6204905284
I20240501000096 TX Practitioner - Nurse Practitioner 6204905284 Reassigns benefits to 1 organization
I20250113003303 TN Practitioner - Nurse Practitioner 6204905284 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP 2208442FLMDNurse Practitioner
APRN.CNP.0039180OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Roman Medical LLC CurrentSince Jul 2, 2016 Accepting new patients
Devoted Medical Group of Texas Inc CurrentSince Apr 16, 2024 Accepting new patients
Devoted Medical Group Professional Corporation CurrentSince Jun 10, 2022 Accepting new patients

Locations

2801 SW 149th Ave
Ste 100
Miramar, FL 33027

880 SW 145th Ave
Ste 202
Pembroke Pines, FL 33027
Phone (615) 275-6612

221 Crescent St
Ste 202
Waltham, MA 02453
Phone (617) 958-1611

3200 West End Ave
Nashville, TN 37203
Phone (615) 510-1646

1201 Fannin St
Ste 262
Houston, TX 77002
Phone (714) 873-6202

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1164446571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211699",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551213699",
            "telephone_number": "866-849-0692",
            "fax_number": "888-973-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 SW 145TH AVE STE 202",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330276171",
            "telephone_number": "866-849-0692",
            "fax_number": "888-973-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGDOR",
        "first_name": "TANYA",
        "name_prefix": "Mrs.",
        "credential": "APRN, ANP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1123902",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP 2208442",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "36844",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.0039180",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "3-001639",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.