Individual provider Active NPI

Tyanne I Graham, CRNP

  • Psychiatry Physician
  • Camp Hill, PA
National Provider Identifier
1225741101
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
SP026685 Issued in PA
Practice address
503 N 21St St
Camp Hill, PA 17011-2204
Phone
(717) 763-2260
Fax
(717) 763-2261
NPI assigned
Jan 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X SP026685 PA Primary

Addresses

Primary practice location

503 N 21St St
Camp Hill, PA 17011-2204

Mailing address

503 N 21St St
Camp Hill, PA 17011-2204
Phone (717) 763-2260

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tgraham2@pennstatehealth.psu.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20230202001719 PA Practitioner - Nurse Practitioner 4688046527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

503 N 21St St
Camp Hill, PA 17011-2204
Phone (717) 972-4301

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
65.84
Promoting interoperability
100
Improvement activities
40
Cost
77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP026685PAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Penn State Health Medical Group, LLC CurrentSince Jan 17, 2023 Accepting new patients
Penn State Health Medical Group, LLC Current Accepting new patients

Locations

503 N 21st St
Camp Hill, PA 17011
Phone (717) 763-2100

1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141

Organizations & group practices 2

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": "1672876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1225741101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 N 21ST ST",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170112204",
            "telephone_number": "717-763-2260",
            "fax_number": "717-763-2261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 N 21ST ST",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170112204",
            "telephone_number": "717-763-2260",
            "fax_number": "717-763-2261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "TYANNE",
        "middle_name": "I",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-05",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "SP026685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tgraham2@pennstatehealth.psu.edu",
            "affiliation": "N",
            "endpointDescription": "e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "e-mail",
            "address_1": "503 N 21st St",
            "city": "Camp Hill",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170112204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Camp Hill, PA

Sources for this page

Verify at the official NPI Registry.