Tanya Ermolovich, D.O.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

OS009218L Issued in PA

Practice address

1259 S Cedar Crest Blvd Ste 100
Allentown, PA 18103-6373

Phone

(610) 437-4134

Fax

(610) 433-9690

NPI assigned

Oct 4, 2005

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 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Specialty

Dermatology

Education

Philadelphia College of Osteopathic Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wilkes-Barre General Hospital Hospital, Wilkes-Barre, PA, CCN 390137

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

• Wilkes Barre Hospital Company LLC

  dba Wilkes Barre General Hospital

  • Clinic/Center
  • Wilkes Barre, PA
  • NPI 1053554378

  Hospital

  Care Compare affiliation
• Wilkes Barre Hospital Company LLC

  dba Wilkes Barre General Hospital

  • General Acute Care Hospital
  • Wilkes Barre, PA
  • NPI 1255585303
  Care Compare affiliation

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1881681971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1259 S CEDAR CREST BLVD",
            "address_2": "SUITE 100",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036206",
            "telephone_number": "610-437-4134",
            "fax_number": "610-770-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1259 S CEDAR CREST BLVD STE 100",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036373",
            "telephone_number": "610-437-4134",
            "fax_number": "610-433-9690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Schuylkill Manor Rd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Pottsville",
            "state": "PA",
            "postal_code": "179013849",
            "country_code": "US",
            "telephone_number": "570-622-6804",
            "fax_number": "570-622-3385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERMOLOVICH",
        "first_name": "TANYA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-04",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "PA",
            "license": "OS009218L",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "OS009218L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "172424",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "02343000",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drtermolovich@adaltd.medentdirect.com",
            "affiliation": "N",
            "address_1": "1259 S Cedar Crest Blvd",
            "address_2": "Suite 100",
            "city": "Allentown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "181036206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Megan N Eppley, OTR/L
• Maria C Erazo, MD
• Sandra Erdman, PA-C
• Jordan Noelle Erickson, MS, LCGC
• Paul Ericson, MD
• Kimberly Ann Ernst-Ganey, M.ED.
• Hannah Rose Ervey, DO
• Devon Ervin, M.S.
• Giovanny Francisco Escribano
• Maria Escudero-Fung

• Dermatology Physician in Allentown, PA
• Providers in Allentown, PA by specialty
• Dermatology Physician in Pennsylvania

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