Individual provider Active NPI

David Paul Tanier, PMHNP-BC

  • Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1457949463
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP023019 Issued in PA
Practice address
1427 Vine St FL 8
Philadelphia, PA 19102-1040
Phone
(267) 507-6581
Fax
(215) 762-6673
NPI assigned
Jan 5, 2021
Last updated
Dec 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP023019 PA Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP023019 PA

Addresses

Primary practice location

1427 Vine St FL 8
Philadelphia, PA 19102-1040

Mailing address

PO Box 13579
Reading, PA 19612-3579

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
I20210311002166 PA Practitioner - Nurse Practitioner 2961818281 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1427 Vine St
FL 8
Philadelphia, PA 19102-1040
Phone (267) 507-6581

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Drexel Academic Medical Group LLC CurrentSince Jun 17, 2024 Accepting new patients
Tower Drexel Academic Medical Group LLC CurrentSince Jun 17, 2024 Accepting new patients
Tower Drexel Academic Medical Group LLC Current Accepting new patients

Locations

1427 Vine St
Fl 8
Philadelphia, PA 19102
Phone (215) 762-6660

219 N Broad St
Fl 6
Philadelphia, PA 19107
Phone (215) 762-5037

Organizations & group practices 4

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": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1457949463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1427 VINE ST FL 8",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021040",
            "telephone_number": "267-507-6581",
            "fax_number": "215-762-6673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANIER",
        "first_name": "DAVID",
        "middle_name": "PAUL",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-05",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP023019",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP023019",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.