Individual provider Active NPI

Shannon Dale Tobiaz

  • Nurse Practitioner
  • Lansdale, PA
National Provider Identifier
1629910831
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP035734 Issued in PA
Practice address
826 N Broad St
Lansdale, PA 19446-2321
Phone
(215) 855-1054
NPI assigned
Apr 7, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP035734 PA Primary

Addresses

Primary practice location

826 N Broad St
Lansdale, PA 19446-2321

Mailing address

817 Rose LN
Hatfield, PA 19440-3149
Phone (484) 358-6617

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
I20260518003732 PA Practitioner - Nurse Practitioner 5395214464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2026
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Green and Seidner Family Practice Associates PCGroup PAC ID 8123001872, 11 clinicians

Practice addresses (Care Compare)

826 N Broad St
Lansdale, PA 19446-2321
Phone (215) 855-1054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP035734PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Green and Seidner Family Practice Associates PC PastSince Jun 1, 2026 Accepting new patients
Lansdale Hospital Corporation PastSince Jun 1, 2026 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1775520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1629910831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 ROSE LN",
            "city": "HATFIELD",
            "state": "PA",
            "postal_code": "194403149",
            "telephone_number": "484-358-6617",
            "fax_number": "484-358-6617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 N BROAD ST",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194462321",
            "telephone_number": "215-855-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIAZ",
        "first_name": "SHANNON",
        "middle_name": "DALE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-07",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP035734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansdale, PA

Sources for this page

Verify at the official NPI Registry.