Individual provider Active NPI

Kathryn Tanner

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1275949497
Registry record updated Dec 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
339462 Issued in NY
Practice address
1894 Walton Ave
Bronx, NY 10453-6018
Phone
(718) 583-3060
NPI assigned
Jul 8, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 671939 NY
Family Nurse Practitioner 363LF0000X 339462 NY Primary

Addresses

Primary practice location

1894 Walton Ave
Bronx, NY 10453-6018

Mailing address

1894 Walton Ave
Bronx, NY 10453-6018
Phone (718) 583-3060

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
I20150611000399 NY Practitioner - Nurse Practitioner 5698096998 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Missouri, Columbia School of Medicine, 2015
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
671939NYMDRegistered Nurse
339462NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Institute for Family Health CurrentSince Mar 27, 2015 Accepting new patients
The Institute for Family Health Current Accepting new patients
Montefiore Medical Center CurrentSince May 10, 2024 Accepting new patients
Montefiore Medical Center CurrentSince May 10, 2024 Accepting new patients
The Institute for Family Health CurrentSince Mar 27, 2015 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1894 Walton Ave
Bronx, NY 10453
Phone (718) 583-2508

279 Main St
Ste 101
New Paltz, NY 12561
Phone (845) 255-2930

1824 Madison Ave
New York, NY 10035
Phone (212) 423-4200

100 Corporate Dr
#100
Yonkers, NY 10701

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: ktanner@montefioredirect.com
  • Direct secure messaging: kathryn.tanner.1@24989.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482364800000",
    "number": "1275949497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1894 WALTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104536018",
            "telephone_number": "718-583-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1894 WALTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104536018",
            "telephone_number": "718-583-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "KATHRYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-08",
        "last_updated": "2016-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "671939",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "339462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.