Tanima Yaibuathes, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F305522-1 Issued in NY

Practice address

149 Commack Rd Ste a
Commack, NY 11725-3459

Phone

(631) 462-2200

NPI assigned

Jun 22, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tanima.yaibuathes@sbcm.cernerdirect.com

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.

• Stony Brook Internists, University Faculty Practice Corporation

  • Internal Medicine Physician
  • Stony Brook, NY
  • NPI 1821035601
  Medicare reassignment NPD

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308700800000",
    "number": "1669768255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 HILLBERRY LN",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117412044",
            "telephone_number": "631-588-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 COMMACK RD STE A",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253459",
            "telephone_number": "631-462-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAIBUATHES",
        "first_name": "TANIMA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-22",
        "last_updated": "2011-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F305522-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• H William Wolfson, DC
• Jessica Woltmann
• Andrea M Worthman, M.S
• James Michael Wyler, LMHC,NCC,CASAC
• Laurence A Wynn, DDS
• Irene C Yarusso, ANP-C
• Regina Yavel, M.D.
• Carolyn M Yeager, PHD
• Raymond J. Yeager, PH.D.
• Amy M Yee

• Adult Health Nurse Practitioner in Commack, NY
• Providers in Commack, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; 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.

Verify at the official NPI Registry.