Kristin Amanda Tatarka, RN, FNP-BC, ACNS-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

COA. 17884-NP Issued in OH

Practice address

8440 Market St
Youngstown, OH 44512-6703

Phone

(330) 965-9999

Fax

(330) 757-0000

NPI assigned

Feb 7, 2015

Last updated

Feb 28, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Kristin Amanda Ponzani Former name

Medicare fee-for-service enrollment

Enrolled in OH

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Serenity Center of Youngstown LLCGroup PAC ID 3870893472, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Serenity Center of Youngstown, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • North Lima, OH
  • NPI 1760861249
  Medicare reassignment Care Compare group NPD
• Crossroads Hospice of Northeast Ohio, LLC

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Uniontown, OH
  • NPI 1831806173
  NPD

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

{
    "created_epoch": "1423267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1821489220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2218 E MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444836106",
            "telephone_number": "330-392-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8440 MARKET ST",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445126703",
            "telephone_number": "330-965-9999",
            "fax_number": "330-757-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATARKA",
        "first_name": "KRISTIN",
        "middle_name": "AMANDA",
        "credential": "RN, FNP-BC, ACNS-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-07",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA. 17884-NP",
            "primary": true
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "OH",
            "license": "COA. 16690-NS",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0231015",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "PONZANI",
            "middle_name": "AMANDA",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eugene F Tareshawty, M.D.
• Summer Lee Tarr, BAAS
• Madeline McNeil Tarrillion, D.O.
• Salestine Tarver
• Kassandra Tassie
• Karleisha Jerice Tate-Layton
• Davanzo Tate Jr.
• Valerie Denise Tate
• Candace Lauren Tavzel
• Aleighja Taylor

• Family Nurse Practitioner in Youngstown, OH
• Providers in Youngstown, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; 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.