Johanna D Tarallo, ANP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F301648 Issued in NY

Practice address

4914 W Seneca Tpke
Syracuse, NY 13215-2225

Phone

(315) 468-2827

Fax

(315) 469-1742

NPI assigned

Feb 5, 2007

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jtarallo163045@direct-guthrie.org

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.

• Roger G Levine MD

  • Psychiatric Residential Treatment Facility
  • Syracuse, NY
  • NPI 1083004907
  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164561536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 EUCLID AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102610",
            "telephone_number": "315-474-2439",
            "fax_number": "315-469-1742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4914 W SENECA TPKE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132152225",
            "telephone_number": "315-468-2827",
            "fax_number": "315-469-1742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARALLO",
        "first_name": "JOHANNA",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F301648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Brooke Tanner, LCSW
• Meredith Wood Tanner, FNP-C
• John Frank Tanquary, M.D.
• Christopher Thomas Tanski, M.D.
• Fnu Tanvir
• Kyle Taranto, MSW-LP
• Matthew Taranto, PHARMD.
• Jennifer Lynn Tarasevich, D.P.T.
• Bedirhan Tarhan, MD
• Nicole Marie Tari

• Psychiatric/Mental Health Nurse Practitioner in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.