Individual provider Active NPI

Tatyana Simutkin, CRNP

  • Family Nurse Practitioner
  • Reading, PA
National Provider Identifier
1356875884
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP017424 Issued in PA
Practice address
20 Shelbourne Rd
Reading, PA 19606-3675
Phone
(610) 404-3200
NPI assigned
Apr 11, 2017
Last updated
Oct 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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 SP017424 PA Primary

Addresses

Primary practice location

20 Shelbourne Rd
Reading, PA 19606-3675

Mailing address

53 Michael LN Apt 3
Denver, PA 17517-9247
Phone (717) 799-8398

Other practice location 1

1623 Morgantown Rd
Reading, PA 19607-9455
Phone (866) 501-5962

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
I20171102001157 PA Practitioner - Nurse Practitioner 4284990524 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP017424PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services CurrentSince Oct 9, 2023 Accepting new patients
Pinnacle Health Medical Services CurrentSince Oct 9, 2023 Accepting new patients
Central Health Management, Inc. CurrentSince Oct 11, 2024 Accepting new patients
Dermatology Physicians Inc. CurrentSince Mar 19, 2019 Accepting new patients
Pinnacle Health Medical Services Current Accepting new patients
CHM Mobile Care Past Accepting new patients

Locations

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

1160 Manheim Pike
Ste 202
Lancaster, PA 17601

203 N Lime St
Lancaster, PA 17602
Phone (717) 392-6267

1850 Normandie Dr
York, PA 17408
Phone (717) 764-4251

Organizations & group practices 6

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": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1356875884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 MICHAEL LN APT 3",
            "city": "DENVER",
            "state": "PA",
            "postal_code": "175179247",
            "telephone_number": "717-799-8398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 SHELBOURNE RD",
            "city": "READING",
            "state": "PA",
            "postal_code": "196063675",
            "telephone_number": "610-404-3200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1623 Morgantown Rd",
            "address_purpose": "LOCATION",
            "city": "Reading",
            "state": "PA",
            "postal_code": "196079455",
            "country_code": "US",
            "telephone_number": "866-501-5962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMUTKIN",
        "first_name": "TATYANA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-11",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP017424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reading, PA

Sources for this page

Verify at the official NPI Registry.