Individual provider Active NPI

Miyako Tamada

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1861154403
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP023521 Issued in PA
Practice address
7515 Stenton Ave
Philadelphia, PA 19150-3710
Phone
(215) 842-5246
NPI assigned
Oct 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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 SP023521 PA Primary

Addresses

Primary practice location

7515 Stenton Ave
Philadelphia, PA 19150-3710

Mailing address

513 Patricia Dr
Glenside, PA 19038-2824
Phone (215) 300-2710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20211203000672 PA Practitioner - Nurse Practitioner 7113317280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.2 of 100Reported as group
Quality
70
Promoting interoperability
93
Improvement activities
20
Cost
88.18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Medical Center CurrentSince Nov 2, 2021 Accepting new patients

Locations

208 W Chelten Ave
Philadelphia, PA 19144
Phone (215) 849-3104

703 Cecil B Moore Ave
Philadelphia, PA 19122
Phone (215) 457-7246

7515 Stenton Ave
Philadelphia, PA 19150
Phone (215) 842-5246

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25233/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1633910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1861154403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 PATRICIA DR",
            "city": "GLENSIDE",
            "state": "PA",
            "postal_code": "190382824",
            "telephone_number": "215-300-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7515 STENTON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191503710",
            "telephone_number": "215-842-5246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMADA",
        "first_name": "MIYAKO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-11",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP023521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.