Individual provider Active NPI

Tatyana Armstead, FNP

  • Family Nurse Practitioner
  • Fort Drum, NY
National Provider Identifier
1538620133
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95021512 Issued in CA
Practice address
11050 Mt Belvedere Blvd
Fort Drum, NY 13602-2603
Phone
(315) 772-4435
NPI assigned
Mar 27, 2019
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95021512 CA Primary
Family Nurse Practitioner 363LF0000X 223195 AZ
Family Nurse Practitioner 363LF0000X 358598 NY

Addresses

Primary practice location

11050 Mt Belvedere Blvd
Fort Drum, NY 13602-2603

Mailing address

11050 Mt Belvedere Blvd
Fort Drum, NY 13602-2603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190426002305 AZ Practitioner - Nurse Practitioner 8224370051
I20221115001268 CA Practitioner - Nurse Practitioner 8224370051 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinicas de Salud del Pueblo, Inc CurrentSince Aug 8, 2022 Accepting new patients
Bullhead Urgent Care Corp CurrentSince Mar 27, 2019 Accepting new patients
Clinicas de Salud del Pueblo, Inc Current Accepting new patients
Clinicas de Salud del Pueblo Inc. CurrentSince Aug 8, 2022 Accepting new patients
Clinicas de Salud del Pueblo, Inc. Past Accepting new patients
Mohave Desert Radiology PLC PastSince Mar 27, 2019 Accepting new patients

Locations

1355 Ramar Rd
Ste 11
Bullhead City, AZ 86442
Phone (928) 704-9202

321 W Hobsonway
Ste C
Blythe, CA 92225
Phone (760) 922-4981

852 E Danenberg Dr
El Centro, CA 92243
Phone (760) 352-2257

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: tatyana.armstead.p1@direct.cdsdp.nextgenshare.com

Organizations & group practices 6

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": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1538620133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11050 MT BELVEDERE BLVD",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136022603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 MT BELVEDERE BLVD",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136022603",
            "telephone_number": "315-772-4435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARMSTEAD",
        "first_name": "TATYANA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95021512",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "223195",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "358598",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Drum, NY

Sources for this page

Verify at the official NPI Registry.