Tabetha Tanae Tyndale, NURSE PRACTITIONER

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

310924 Issued in NY

Practice address

1477 Hylan Blvd
Staten Island, NY 10305-1906

Phone

(718) 979-6900

NPI assigned

Aug 21, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tabetha.tyndale.p1@direct.ezramedical.nextgenshare.com
• Direct secure messaging: tabetha.tyndale.1@25238.direct.athenahealth.com

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.

• Mylaurel Medical Group Ny, PLLC

  • General Practice Physician
  • New York, NY
  • NPI 1477214237
  Medicare reassignment NPD
• Homemakers of Staten Island, Inc.

  • Home Health Agency
  • Staten Island, NY
  • NPI 1952462806
  NPD (past)

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

{
    "created_epoch": "1219276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1508013442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 W BUCHANAN ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103011224",
            "telephone_number": "347-466-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1477 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051906",
            "telephone_number": "718-979-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYNDALE",
        "first_name": "TABETHA",
        "middle_name": "TANAE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-21",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "287510-1",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "310924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frances Jennie Twomey
• Priya Tyagi
• Veronika Tyatina, PHARMD
• Susan Merle Tyburczy, PH.D.
• Edison Tyli, NP
• Michael Tyshkov, MD
• Christina Michelle Ucelli, MA
• Chukwukelue Nwabueze Uchefuna, MD
• Salvatore Anthony Uggiano III, PA
• Derek F Ugwendum, MD

• Gerontology Nurse Practitioner in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Gerontology Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.