Individual provider Active NPI

Tangneka Miracle Nguyen, PA-C

  • Physician Assistant
  • Elmira, NY
National Provider Identifier
1649155045
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
034250 Issued in NY
Practice address
950 County Road 64 Ste 100
Elmira, NY 14903-9711
Phone
(607) 796-5900
Fax
(646) 665-3604
NPI assigned
Aug 6, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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 034250 NY Primary

Addresses

Primary practice location

950 County Road 64 Ste 100
Elmira, NY 14903-9711

Mailing address

15 W 27TH St FL 11
New York, NY 10001-7711
Phone (212) 283-3000

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
I20250823000047 NY Practitioner - Physician Assistant 8022518141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia College of Osteopathic Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Schweiger Dermatology PLLCGroup PAC ID 5991947160, 254 clinicians

Practice addresses (Care Compare)

2500 Western Ave
Altamont, NY 12009-9485
Phone (518) 690-0177

2508 Western Ave
Altamont, NY 12009-9485
Phone (518) 690-0177

950 County Rd
64 Suite 100
Elmira, NY 14903-9711
Phone (212) 283-3000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Tier Dermatology & Aesthetics Dermatology PastSince Aug 10, 2025 Accepting new patients
Schweiger Dermatology, PC Dermatology Past Accepting new patients

Networks

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

Organizations & group practices 3

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": "1754438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1649155045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 W 27TH ST FL 11",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100017711",
            "telephone_number": "212-283-3000",
            "fax_number": "646-665-3604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 COUNTY ROAD 64 STE 100",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149039711",
            "telephone_number": "607-796-5900",
            "fax_number": "646-665-3604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TANGNEKA",
        "middle_name": "MIRACLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-06",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "034250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

Verify at the official NPI Registry.