NPIMap

Individual provider Active NPI

Shayla Tatham

  • Family Nurse Practitioner
  • Cuba, NY
National Provider Identifier
1407549066
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
351972 Issued in NY
Practice address
45 W Main St
Cuba, NY 14727-1403
Phone
(585) 968-1628
NPI assigned
May 31, 2023
Last updated
May 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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 351972 NY Primary

Addresses

Primary practice location

45 W Main St
Cuba, NY 14727-1403

Mailing address

535 Main St
Olean, NY 14760-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20230717000991 NY Practitioner - Nurse Practitioner 4981064425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Olean Medical Practice PLLCGroup PAC ID 0042698045, 56 clinicians

Practice addresses (Care Compare)

45 W Main St
Cuba, NY 14727-1403
Phone (585) 968-1628

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician, PC CurrentSince Aug 1, 2023 Accepting new patients
Olean Medical Practice PLLC Current Accepting new patients
General Physician, PC CurrentSince Aug 1, 2023 Accepting new patients

Locations

45 W Main St
Cuba, NY 14727
Phone (585) 307-9645

535 Main St
Olean, NY 14760
Phone (716) 372-0141

535 Main St
Ste 1
Olean, NY 14760
Phone (716) 372-0141

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1407549066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 MAIN ST",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147601500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 W MAIN ST",
            "city": "CUBA",
            "state": "NY",
            "postal_code": "147271403",
            "telephone_number": "585-968-1628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATHAM",
        "first_name": "SHAYLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-31",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "351972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cuba, NY

Sources for this page

Verify at the official NPI Registry.