Active NPI
Tenzin Yangzom
- Family Nurse Practitioner
- Bridgeport, CT
National Provider Identifier
1912610676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 11370
- Practice address
- 3180 Main St
Bridgeport, CT 06606-4237 - Phone
- (203) 373-1593
- NPI assigned
- Dec 27, 2022
- Last updated
- Feb 11, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 11370 | CT | Primary |
Addresses
Primary practice location
3180 Main St
Bridgeport, CT 06606-4237
Mailing address
3180 Main St
Bridgeport, CT 06606-4237
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11370 | CT | MD | Clinical Social Worker |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Core Medical Group
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- Bridgeport, CT
- NPI 1609014893
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676073600000",
"number": "1912610676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3180 MAIN ST",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066064237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3180 MAIN ST",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066064237",
"telephone_number": "203-373-1593"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YANGZOM",
"first_name": "TENZIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-27",
"last_updated": "2023-02-11",
"certification_date": "2023-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CT",
"license": "11370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.