Individual provider Active NPI

Tamara Massengale, NURSE PRACTITIONER

  • Adult Health Nurse Practitioner
  • Ithaca, NY
National Provider Identifier
1841953593
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F310599 Issued in NY
Practice address
334 W State St
Ithaca, NY 14850-5432
Phone
(607) 273-5500
NPI assigned
Oct 20, 2021
Last updated
Jan 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F310599 NY Primary
Family Nurse Practitioner 363LF0000X 310599 NY
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

334 W State St
Ithaca, NY 14850-5432

Mailing address

169 Riverside Dr
Binghamton, NY 13905-4246

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
I20220106002043 NY Practitioner - Nurse Practitioner 5698166338 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

33 Mitchell Ave
Binghamton, NY 13903-1642
Phone (607) 762-3281

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F310599NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of Lourdes Memorial Hospital, Inc. Current Accepting new patients
Our Lady of Lourdes Memorial Hospital Inc. CurrentSince Jan 19, 2022 Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Jan 19, 2022 Accepting new patients
Twin Tier Pathology Associates, PC Current Accepting new patients
United Health Services Hospitals, Inc. CurrentSince Jan 19, 2026 Accepting new patients
Riverside Dental Associates, LLP PastSince Oct 1, 2021 Accepting new patients

Locations

10-42 Mitchell Ave
Binghamton, NY 13903
Phone (607) 762-2468

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

169 Riverside Dr
Ste 206
Binghamton, NY 13905
Phone (607) 798-6701

33 Mitchell Ave
Binghamton, NY 13903
Phone (607) 762-2340

500 5th Ave
Owego, NY 13827
Phone (607) 687-1122

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1841953593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 RIVERSIDE DR",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139054246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 W STATE ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505432",
            "telephone_number": "607-273-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSENGALE",
        "first_name": "TAMARA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-20",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F310599",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "310599",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.