Individual provider Active NPI

Tiffany Reid, NP-C

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1912447533
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F0117076 Issued in PA
Practice address
4510 Frankford Ave
Philadelphia, PA 19124-3602
Phone
(215) 744-1302
Fax
(215) 744-2544
NPI assigned
Mar 1, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

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 F0117076 PA Primary

Addresses

Primary practice location

4510 Frankford Ave
Philadelphia, PA 19124-3602

Mailing address

1401 S 31St St FL 2
Philadelphia, PA 19146-3506
Phone (215) 925-2400

Other practice location 1

4939 N 10th St
Philadelphia, PA 19141-3901
Phone (267) 249-4475

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
I20170523000434 PA Practitioner - Nurse Practitioner 0840567822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greater Philadelphia Health Action IncGroup PAC ID 9537064977, 70 clinicians

Practice addresses (Care Compare)

1999 W Hunting Park Ave
Philadelphia, PA 19140-2828
Phone (215) 228-9300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F0117076PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Philadelphia Health Action, Inc. CurrentSince Dec 18, 2019 Accepting new patients
Greater Philadelphia Health Action Inc. CurrentSince Dec 18, 2019 Accepting new patients

Locations

5501 Woodland Ave
Philadelphia, PA 19143
Phone (215) 724-4700

1401 S 31st St
#2
Philadelphia, PA 19146

1401 S 31st St
Philadelphia, PA 19146
Phone (215) 755-7700

4510 Frankford Ave
Philadelphia, PA 19124
Phone (215) 744-1302

432 N 6th St
Philadelphia, PA 19123
Phone (215) 627-8000

Interoperability endpoints

  • Direct secure messaging: tiffany.reid.p1@direct.gpha.nextgenshare.com

Organizations & group practices 2

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": "1488326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1912447533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S 31ST ST FL 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191463506",
            "telephone_number": "215-925-2400",
            "fax_number": "215-925-9162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 FRANKFORD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191243602",
            "telephone_number": "215-744-1302",
            "fax_number": "215-744-2544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4939 N 10th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191413901",
            "country_code": "US",
            "telephone_number": "267-249-4475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REID",
        "first_name": "TIFFANY",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-01",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "F0117076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.