Individual provider Active NPI

Tanaeya Bradley, NP

  • Nurse Practitioner
  • Willingboro, NJ
National Provider Identifier
1992404610
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ01437400 Issued in NJ
Practice address
4318 US 130
Willingboro, NJ 08046
Phone
(609) 871-2045
NPI assigned
Mar 2, 2023
Last updated
Aug 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ01437400 NJ Primary

Addresses

Primary practice location

4318 US 130
Willingboro, NJ 08046

Mailing address

PO Box 95
Willingboro, NJ 08046-0095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230427003147 NJ Practitioner - Nurse Practitioner 6305201294 Reassigns benefits to 3 organizations
I20240501003180 PA Practitioner - Nurse Practitioner 6305201294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DRX Paramus, LLCGroup PAC ID 2466589585, 63 clinicians
MHP MD PLLCGroup PAC ID 6507258423, 45 clinicians

Practice addresses (Care Compare)

2001 College Dr
Suite 11
Clementon, NJ 08021-5617
Phone (856) 566-3333

2401 W Cheltenham Ave
Suite 132
Wyncote, PA 19095-2946
Phone (267) 415-6045

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DRX Paramus, LLC CurrentSince Oct 13, 2024 Accepting new patients
Prohealth Urgent Care Medicine of New Jersey LLP CurrentSince Apr 1, 2023 Accepting new patients
MHP MD PLLC CurrentSince Mar 27, 2024 Accepting new patients
GT Urgent Care PC PastSince Oct 13, 2024 Accepting new patients
Jersey Irish Medical PastSince Oct 26, 2019 Accepting new patients

Locations

1210 Route 130 N
Ste 1438
Cinnaminson, NJ 08077
Phone (551) 313-0170

2001 College Dr
Ste 11
Clementon, NJ 08021
Phone (856) 566-3333

1410 Delsea Dr
Fl 2
Deptford, NJ 08096
Phone (856) 579-8897

67 E Ridgewood Ave
Unit C
Paramus, NJ 07652
Phone (201) 262-2010

1 Harmon Plz
Ste 1010
Secaucus, NJ 07094

400 Fayette St
Ste 180
Conshohocken, PA 19428
Phone (484) 243-6622

48 E Ridge Pike
#A
Conshohocken, PA 19428
Phone (484) 243-6730

180 W Girard Ave
Ste 108
Philadelphia, PA 19123
Phone (267) 319-8047

2401 W Cheltenham Ave
Ste 132
Wyncote, PA 19095
Phone (215) 935-6777

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1677715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1992404610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080460095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4318 US 130",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "08046",
            "telephone_number": "609-871-2045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "TANAEYA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-02",
        "last_updated": "2025-08-05",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ01437400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willingboro, NJ

Sources for this page

Verify at the official NPI Registry.