Individual provider Active NPI

Tanya Prabhakar

  • Primary Care Nurse Practitioner
  • New York, NY
National Provider Identifier
1508671231
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
354211 Issued in NY
Practice address
555 Broome St
New York, NY 10013-1510
Phone
(212) 453-0222
NPI assigned
Feb 10, 2025
Last updated
Feb 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 354211 NY Primary

Addresses

Primary practice location

555 Broome St
New York, NY 10013-1510

Mailing address

555 Broome St
New York, NY 10013-1510

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
I20250423002469 NY Practitioner - Nurse Practitioner 0648795526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

555 Broome St
New York, NY 10013-1510
Phone (212) 941-9090

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Door - a Center of Alternatives, Inc. CurrentSince Mar 15, 2025 Accepting new patients
The Door - a Center of Alternatives, Inc. CurrentSince Feb 23, 2025 Accepting new patients

Locations

555 Broome St
New York, NY 10013
Phone (212) 453-0222

555 Broome St
Fl 3
New York, NY 10013
Phone (212) 941-9090

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.

NPI Registry JSON

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

{
    "created_epoch": "1739145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1508671231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 BROOME ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100131510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 BROOME ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100131510",
            "telephone_number": "212-453-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRABHAKAR",
        "first_name": "TANYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "354211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.