Hermina Kwangsa Tandia, DNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2023127704 Issued in IA

Practice address

1932 SW 3Rd St Ste 4
Ankeny, IA 50023-2400

Phone

(641) 980-5031

NPI assigned

Nov 6, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

University of Iowa, RJ & L Carver College of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

WR Jacobs Enterprises LLC 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• WR Jacobs Enterprises, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ankeny, IA
  • NPI 1104519065

  IA

  Medicare reassignment Care Compare group NPD
• First Vision Healthcare Services

  • In Home Supportive Care Agency
  • Ankeny, IA
  • NPI 1376208520
  NPD Authorized official
• Lifebridge Iowa

  • In Home Supportive Care Agency
  • Ankeny, IA
  • NPI 1720977671
  NPD Authorized official
• Lumina Iowa Psychiatry Professional Corporation

  • Adult Mental Health Clinic/Center
  • Ankeny, IA
  • NPI 1598612095
  NPD Authorized official

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1871366468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 NE 45TH ST",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500216734",
            "telephone_number": "641-980-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1932 SW 3RD ST STE 4",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500232400",
            "telephone_number": "641-980-5031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANDIA",
        "first_name": "HERMINA",
        "middle_name": "KWANGSA",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "2023127704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mallory Jo Swenson, DPT
• Djuna (DJ) Swope, MSW, LISW
• Rhonda Lynn Dodge Syata, MD
• Madison Taborek, PA
• Tandem Services
• Claire Elizabeth Tangman, OD
• Jordan Richard Tanko, D.C.
• Amna Tanweer, DO
• John C Tapp, DO
• Tara J. Smith, Arnp, PLLC

• All providers in Ankeny, IA
• Psychiatric/Mental Health Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.