Individual provider Active NPI

Tinashe Mudiwa, FNP

  • Family Nurse Practitioner
  • White Plains, NY
National Provider Identifier
1740632876
Registry record updated Apr 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F340509 Issued in NY
Practice address
210 Westchester Ave
White Plains, NY 10604-2901
Phone
(914) 831-6850
NPI assigned
Jul 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F340509 NY Primary

Addresses

Primary practice location

210 Westchester Ave
White Plains, NY 10604-2901

Mailing address

2700 Westchester Ave
FL 2
Purchase, NY 10577-2547
Phone (914) 607-5730

Other names 1

  • Tinashe Mudiwa-Heath Former name

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
I20180322002040 NY Practitioner - Nurse Practitioner 7911269386 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Perry Ave Family Medical Center IncGroup PAC ID 0547365363, 28 clinicians

Practice addresses (Care Compare)

3071 Perry Ave
Bronx, NY 10467-4111
Phone (718) 231-6700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F340509NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Parcare Community Health Network Inc CurrentSince Jan 1, 2024 Accepting new patients
Parcare Community Health Network Inc CurrentSince Jan 1, 2024 Accepting new patients
Rockwell Health LLC CurrentSince Apr 29, 2024 Accepting new patients
Perry Ave Family Medical Center Inc CurrentSince Jan 1, 2025 Accepting new patients
Beacon Health Medical PC CurrentSince Oct 1, 2024 Accepting new patients
Omar Osman MD PLLC CurrentSince May 15, 2023 Accepting new patients
Ilyagu Medical PC Past Accepting new patients

Locations

415 W Golf Rd
Ste 26
Arlington Hts, IL 60005

3071 Perry Ave
Bronx, NY 10467
Phone (718) 231-6700

691 92nd St
Brooklyn, NY 11228
Phone (718) 567-1000

202 Caton Ave
Brooklyn, NY 11218

17 W 9th St
Brooklyn, NY 11231
Phone (718) 599-9090

445 Park Ave
Brooklyn, NY 11205
Phone (718) 965-1320

822 Cedar Ave
Niagara Falls, NY 14301
Phone (716) 272-1207

91 Tompkins Ave
Staten Island, NY 10304
Phone (718) 876-1200

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HHFGDD
  • Direct secure messaging: tim9020@direct.weillcornell.org

Organizations & group practices 7

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": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1740632876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 WESTCHESTER AVE",
            "address_2": "FL 2",
            "city": "PURCHASE",
            "state": "NY",
            "postal_code": "105772547",
            "telephone_number": "914-607-5730",
            "fax_number": "914-457-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 WESTCHESTER AVE",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106042901",
            "telephone_number": "914-831-6850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDIWA",
        "first_name": "TINASHE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-13",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F340509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINASHE",
            "last_name": "MUDIWA-HEATH",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.