NPIMap

Individual provider Active NPI

Tanya Weidner

  • Family Nurse Practitioner
  • Allentown, PA
National Provider Identifier
1295377596
Registry record updated Oct 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP020902 Issued in PA
Practice address
1240 S Cedar Crest Blvd Ste 401
Allentown, PA 18103-6218
Phone
(610) 402-3650
Fax
(610) 402-3673
NPI assigned
Oct 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2019

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 SP020902 PA Primary

Addresses

Primary practice location

1240 S Cedar Crest Blvd Ste 401
Allentown, PA 18103-6218

Mailing address

1605 N Cedar Crest Blvd Ste 411
Allentown, PA 18104-2323
Phone (484) 884-4500

Other names 1

  • Tanya Rabenold Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191118001024 PA Practitioner - Nurse Practitioner 6103258934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1240 S Cedar Crest Blvd
401 LVPG Gynecologic Oncology
Allentown, PA 18103-6218
Phone (610) 402-3650

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Oct 21, 2019 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Oct 21, 2019 Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

1240 S Cedar Crest Blvd
Ste 401
Allentown, PA 18103
Phone (610) 402-3650

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

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 11

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": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1295377596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 N CEDAR CREST BLVD STE 411",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181042323",
            "telephone_number": "484-884-4500",
            "fax_number": "484-664-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 S CEDAR CREST BLVD STE 401",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036218",
            "telephone_number": "610-402-3650",
            "fax_number": "610-402-3673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIDNER",
        "first_name": "TANYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-09",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP020902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TANYA",
            "last_name": "RABENOLD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.