Individual provider Active NPI

Kayla Tanen, PA

  • Physician Assistant
  • Hawthorne, NY
National Provider Identifier
1477362572
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
19 Bradhurst Ave Ste 1300
Hawthorne, NY 10532-2140
Phone
(914) 592-2400
NPI assigned
Jan 3, 2025
Last updated
Jan 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

19 Bradhurst Ave Ste 1300
Hawthorne, NY 10532-2140

Mailing address

19 Bradhurst Ave Ste 1300
Hawthorne, NY 10532-2140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250307001001 NY Practitioner - Physician Assistant 1153842026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

19 Bradhurst Ave
Hawthorne, NY 10532-2140

575 Hudson Valley Ave
New Windsor, NY 12553-4746

95 Grasslands Rd
Valhalla, NY 10595-1652
Phone (914) 493-6940

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Mar 1, 2025 Accepting new patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Mar 1, 2025 Accepting new patients

Locations

19 Bradhurst Ave
Ste 3100N
Hawthorne, NY 10532
Phone (914) 231-8373

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 2

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 2

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": "1735862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1477362572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE STE 1300",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE STE 1300",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140",
            "telephone_number": "914-592-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANEN",
        "first_name": "KAYLA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-03",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, NY

Sources for this page

Verify at the official NPI Registry.