Pius Awandem Tanyifor

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

9538 Issued in MN

Practice address

2115 County Road D E Ste 100
Saint Paul, MN 55109-5353

Phone

(651) 358-7020

Fax

(612) 293-6742

NPI assigned

Sep 20, 2022

Sex

Male

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 MN

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pius.tanyifor.1@27921.direct.athenahealth.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.

• Brightstar Behavioral Health Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Albertville, MN
  • NPI 1386510378
  NPD Authorized official

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

{
    "created_epoch": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1679296248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7722 MACKENZIE AVE NE",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553305031",
            "telephone_number": "763-291-3169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 COUNTY ROAD D E STE 100",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551095353",
            "telephone_number": "651-358-7020",
            "fax_number": "612-293-6742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANYIFOR",
        "first_name": "PIUS",
        "middle_name": "AWANDEM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-20",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "9538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kallie Taniguchi
• Marshall H Taniguchi, MD
• Aboubacar Tanimoune
• Connie Tanner
• Lynn Tanner, PHD, PT
• Tapestry
• Tapestry Treatment Center LLC
• Tapestry, LLC
• Alexandra T. Tarabochia-Gast, MD
• Maryna Tarbunova, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.