Tin Tin Wynn, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

2126263 Issued in NY

Practice address

1075 Central Park Ave
Ste 107
Scarsdale, NY 10583-3241

Phone

(800) 750-8616

Fax

(845) 362-8474

NPI assigned

Apr 11, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Rubina Heptulla Physician PLLC

  • Clinic/Center
  • Scarsdale, NY
  • NPI 1699269340
  Medicare reassignment NPD
• JF Medical Services, PC

  • Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
  • West Nyack, NY
  • NPI 1649480336
  NPD (past)
• Park Avenue Medical Associates, P.C.

  • Geriatric Medicine (Family Medicine) Physician
  • White Plains, NY
  • NPI 1730138645
  NPD (past)

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451779200000",
    "number": "1306069976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 FIREMANS MEMORIAL DR",
            "address_2": "115",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109703569",
            "telephone_number": "800-750-8616",
            "fax_number": "845-362-8474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 CENTRAL PARK AVE",
            "address_2": "STE 107",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105833241",
            "telephone_number": "800-750-8616",
            "fax_number": "845-362-8474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "TIN",
        "middle_name": "TIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2016-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "2126263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alice Kane Wolson, DSW
• Jessica Katelyn Woodson
• Marielle Woolf, LCSW
• Wright Choice Physical Therapy
• Kailing Sung Wu, D.D.S.
• Jing Xu, M.D.
• Jeong Ho Yang, D.M.D.
• Jie Yang, P.T.
• Susan Yanni-Bosco, LCSW
• Caryl Yanow, MD

• Physical Medicine & Rehabilitation Physician in Scarsdale, NY
• Providers in Scarsdale, NY by specialty
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.