Tamara Y Smith, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

308468 Issued in NY

Practice address

76 S Central Ave Ste 1a
Valley Stream, NY 11580-5405

Phone

(516) 284-7521

Fax

(516) 475-2600

NPI assigned

Aug 23, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mill Basin Medical Health PCGroup PAC ID 9133566128, 104 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

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

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.

• Ty Smith Nurse Practitioner Adult

  • Primary Care Clinic/Center
  • Valley Stream, NY
  • NPI 1912788613
  Medicare reassignment NPD Authorized official
• Mill Basin Medical Health PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1346006202
  Medicare reassignment Care Compare group
• Suny Downstate Medical Center

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1699704155
  NPD (past)

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706313600000",
    "number": "1871010736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1595 N CENTRAL AVE APT 39",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115801186",
            "telephone_number": "516-284-7521",
            "fax_number": "516-475-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 S CENTRAL AVE STE 1A",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115805405",
            "telephone_number": "516-284-7521",
            "fax_number": "516-475-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TAMARA",
        "middle_name": "Y",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2024-01-27",
        "certification_date": "2024-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "654591",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "308468",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "308468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheray Small
• Selbourne Percival Smart, RN, ONC
• Danielle Nakia Smith, NP
• Sianna Smith
• Sophia Michelle Smith, R.N.
• Nicole Smolin
• Dariel Smuckler, PEER SPECIALIST
• Casey Marie Smyth
• Anna Snapp
• Ji Sun Song, NP

• Gerontology Nurse Practitioner in Valley Stream, NY
• Providers in Valley Stream, NY by specialty
• Gerontology Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2024; 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.