Individual provider Active NPI

Tisha Marie Tanyi, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1205309952
Registry record updated Jan 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402567 Issued in NY
Practice address
1263 Delaware Ave
Buffalo, NY 14209-2402
Phone
(716) 886-8200
NPI assigned
Jan 5, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 402567 NY Primary

Addresses

Primary practice location

1263 Delaware Ave
Buffalo, NY 14209-2402

Mailing address

195 Willowgrove S
Tonawanda, NY 14150-4517
Phone (716) 863-3235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190522001054 NY Practitioner - Nurse Practitioner 5092058644 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Suburban Psychiatric Associates, LLPGroup PAC ID 6709774318, 35 clinicians

Practice addresses (Care Compare)

85 Bryant Woods S
Amherst, NY 14228-3604
Phone (716) 689-3333

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
402567NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brylin Hospitals, Inc. Single Specialty CurrentSince Mar 2, 2019 Accepting new patients
Suburban Psychiatric Associates, LLP Single Specialty CurrentSince Jun 1, 2019 Accepting new patients
Brylin Hospitals, Inc. Single Specialty CurrentSince Mar 2, 2019 Accepting new patients
Kaleida Health Single Specialty Current Accepting new patients

Locations

100 High St
#13282
Buffalo, NY 14203

85 Bryant Woods S
Buffalo, NY 14228
Phone (716) 689-3333

1263 Delaware Ave
Buffalo, NY 14209
Phone (716) 219-3636

1540 Maple Rd
Williamsville, NY 14221
Phone (716) 568-3514

Interoperability endpoints

  • Direct secure messaging: ttanyi@spa.medentdirect.com

Organizations & group practices 4

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": "1546646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546646400000",
    "number": "1205309952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 WILLOWGROVE S",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141504517",
            "telephone_number": "716-863-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1263 DELAWARE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092402",
            "telephone_number": "716-886-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANYI",
        "first_name": "TISHA",
        "middle_name": "MARIE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-05",
        "last_updated": "2019-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.