Individual provider Active NPI

Tanaka Munda

  • Registered Nurse
  • Valley Stream, NY
National Provider Identifier
1366186314
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
839668 Issued in NY
Practice address
18 Vanderbilt Way
Valley Stream, NY 11581-2310
Phone
(718) 415-6788
NPI assigned
Apr 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 839668 NY Primary

Addresses

Primary practice location

18 Vanderbilt Way
Valley Stream, NY 11581-2310

Mailing address

18 Vanderbilt Way
Valley Stream, NY 11581-2310
Phone (718) 415-6788

Other practice location 1

18 Vanderbilt Way
Valley Stream, NY 11581-2310
Phone (718) 415-6788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
839668NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1366186314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 VANDERBILT WAY",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115812310",
            "telephone_number": "718-415-6788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 VANDERBILT WAY",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115812310",
            "telephone_number": "718-415-6788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18 Vanderbilt Way",
            "address_purpose": "LOCATION",
            "city": "Valley Stream",
            "state": "NY",
            "postal_code": "115812310",
            "country_code": "US",
            "telephone_number": "718-415-6788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUNDA",
        "first_name": "TANAKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-26",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "839668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.