Individual provider Active NPI

Ngefek Ntumbong Tayo, CRNP

  • Family Nurse Practitioner
  • Glen Burnie, MD
National Provider Identifier
1174198386
Registry record updated Oct 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R217132 Issued in MD
Practice address
6934 Aviation Blvd Ste F
Glen Burnie, MD 21061-2593
Phone
(410) 760-3588
Fax
(410) 760-3604
NPI assigned
May 21, 2021
Last updated
Oct 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R217132 MD Primary

Addresses

Primary practice location

6934 Aviation Blvd Ste F
Glen Burnie, MD 21061-2593

Mailing address

6934 Aviation Blvd Ste F
Glen Burnie, MD 21061-2593
Phone (410) 760-3588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20211012002398 MD Practitioner - Nurse Practitioner 0244638815 Reassigns benefits to 2 organizations
I20220607003430 DC Practitioner - Nurse Practitioner 0244638815 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Synergy Medical Group LLCGroup PAC ID 0749644177, 102 clinicians
Mid-Atlantic Nephrology Associates PAGroup PAC ID 2769469006, 60 clinicians

Practice addresses (Care Compare)

1205 York Rd
Lutherville, MD 21093-6211
Phone (443) 325-0031

14631 Laurel Bowie Rd
Suite 100
Laurel, MD 20707-4407
Phone (301) 725-3559

6934 Aviation Blvd
Suite F
Glen Burnie, MD 21061-2593
Phone (410) 760-3588

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Medical Group LLC Single Specialty Current Accepting new patients
Mid-Atlantic Nephrology Associates PA Single Specialty CurrentSince Sep 27, 2021 Accepting new patients
Synergy Medical Group LLC CurrentSince Dec 14, 2024 Accepting new patients
Synergy Medical Group LLC CurrentSince Dec 14, 2024 Accepting new patients
Renal Treatment Centers - Mid-Atlantic, Inc. CurrentSince Aug 25, 2024 Accepting new patients
Synergy Medical Group LLC Single Specialty Current Accepting new patients
Synergy Medical Group LLC CurrentSince Dec 14, 2024 Accepting new patients

Locations

6934 Aviation Blvd
Ste F
Glen Burnie, MD 21061
Phone (410) 760-3588

1589 Sulphur Spring Rd
Ste 109
Halethorpe, MD 21227
Phone (410) 536-5400

3210 Powder Mill Rd
Hyattsville, MD 20783
Phone (301) 937-3939

14631 Laurel Bowie Rd
Ste 100
Laurel, MD 20707
Phone (301) 725-3559

299 Hurley Ave
Rockville, MD 20850
Phone (301) 762-8900

1205 York Rd
Ste 11
Timonium, MD 21093
Phone (443) 325-0031

Interoperability endpoints

  • Direct secure messaging: ngefektayo@mana.allscriptsdirect.net

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634860800000",
    "number": "1174198386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6934 AVIATION BLVD STE F",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210612593",
            "telephone_number": "410-760-3588",
            "fax_number": "410-760-3604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6934 AVIATION BLVD STE F",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210612593",
            "telephone_number": "410-760-3588",
            "fax_number": "410-760-3604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYO",
        "first_name": "NGEFEK",
        "middle_name": "NTUMBONG",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-21",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R217132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.