Active NPI
Tanya D Antosy, PA-C
- Surgical Physician Assistant
- Wynnewood, PA
National Provider Identifier
1669667341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- MA05311
- Practice address
- 100 Lancaster Ave
Wynnewood, PA 19096-3450 - Phone
- (484) 476-2000
- NPI assigned
- Sep 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 25MP00279900 | NJ | |
| Medical Physician Assistant | 363AM0700X | MA053181 | PA | |
| Surgical Physician Assistant | 363AS0400X | MA05311 | PA | Primary |
Addresses
Primary practice location
100 Lancaster Ave
Wynnewood, PA 19096-3450
Mailing address
100 Lancaster Ave
Wynnewood, PA 19096-3450
Phone (484) 476-2000
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071210000027 | PA | Practitioner - Physician Assistant | 5395834618 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA053181 | PA | MD | Medical Physician Assistant |
| MA05311 | PA | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Penn-Medical Group | Current | Accepting new patients | |
| University of Penn-Medical Group | Current | Accepting new patients | |
| Clinical Health Care Associates of New Jersey, PC | Past | Accepting new patients |
Locations
250 King of Prussia Rd
Radnor, PA 19087
Phone (610) 902-1800
Organizations & group practices 4
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.
-
- Reproductive Endocrinology Physician
- Philadelphia, PA
- NPI 1245628353
-
- Surgical Oncology Physician
- Philadelphia, PA
- NPI 1871981985
-
- Orthopaedic Surgery Physician
- Cherry Hill, NJ
- NPI 1437288263
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512604800000",
"number": "1669667341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 LANCASTER AVE",
"city": "WYNNEWOOD",
"state": "PA",
"postal_code": "190963450",
"telephone_number": "484-476-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 LANCASTER AVE",
"city": "WYNNEWOOD",
"state": "PA",
"postal_code": "190963450",
"telephone_number": "484-476-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTOSY",
"first_name": "TANYA",
"middle_name": "D",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-06",
"last_updated": "2017-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NJ",
"license": "25MP00279900",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": "MA053181",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "PA",
"license": "MA05311",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wynnewood, PA
- Mary Jucel P Angeles, CRNP
- Annesley Flanagan Fischer Stefanyszyn and Associates
- Anthony Marziano Jr BSC MPT PC
- Alexander P Anthopoulos, M.D.
- Margot Antonello, CRNP
- Victory Anyiam, DC
- Aranaas Home Health Care Agency LLC
- Jonathan L Arend, M.D.
- Hima Arramraju, PHYSICIANS ASSISTANT
- Michael Sam Ascher, M.D
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2017; 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.