Individual provider Active NPI

Alenna Tamayo, CPNP-AC

  • Pediatric Nurse Practitioner
  • Austin, TX
National Provider Identifier
1376896266
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
756153 Issued in TX
Practice address
4900 Mueller Blvd
Austin, TX 78723-3079
Phone
(512) 324-0165
NPI assigned
Oct 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 756153 TX Primary

Addresses

Primary practice location

4900 Mueller Blvd
Austin, TX 78723-3079

Mailing address

1601 Rio Grande St
Suite 340
Austin, TX 78701-1137

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20121101000643 TX Practitioner - Nurse Practitioner 5698925477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dell Childrens Medical GroupGroup PAC ID 8224092978, 117 clinicians

Practice addresses (Care Compare)

1301 Barbara Jordan Blvd
Austin, TX 78723-3078

4900 Mueller Blvd
Austin, TX 78723-3051
Phone (512) 324-0000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
756153TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dell Children'S Medical Group CurrentSince Feb 1, 2014 Accepting new patients
Dell Children'S Medical Group CurrentSince Feb 1, 2014 Accepting new patients
Seton Family of Doctors Past Accepting new patients

Locations

4900 Mueller Blvd
Austin, TX 78723
Phone (512) 324-0165

1301 Barbara Jordan Blvd
Ste 200
Austin, TX 78723
Phone (512) 628-1800

Interoperability endpoints

  • Direct secure messaging: alenna.tamayo.2@8363.direct.athenahealth.com
  • Direct secure messaging: alenna.tamayo.1@8363.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1376896266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 RIO GRANDE ST",
            "address_2": "SUITE 340",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787011137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 MUELLER BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233079",
            "telephone_number": "512-324-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMAYO",
        "first_name": "ALENNA",
        "credential": "CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-17",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "756153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.