Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tabetha Tanae Tyndale, NURSEPRACTITIONER

Individual provider Licensed Practical Nurse · NPI 1508013442

Tabetha Tanae Tyndale, NURSEPRACTITIONER is a Nurse Practitioner in Staten Island, New York. Qualified in 2022, 4 years ago. Practices with Mylaurel Medical Group Ny, PLLC, a 15-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
4
Licensed in
NY
In the registry since
2008
Specialties on file
2
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Practice location Address checks out

1477 Hylan Blvd
Staten Island, NY 10305-1906
Phone: (718) 979-6900
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 310924 (NY)
Licensed Practical Nurse Taxonomy 164W00000X · Licence 287510-1 (NY)

Record details

NPI number1508013442
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorYes
NPI enumeratedAugust 21, 2008
Last updated in NPPESFebruary 20, 2025
Certification dateFebruary 20, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Mylaurel Medical Group Ny, Pllc — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Staten Island