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

Tara Hyneman

Individual provider Obstetrics & Gynecology Nurse Practitioner · NPI 1518857440

Tara Hyneman is a Nurse Practitioner in Gouverneur, New York. Qualified in 2025, 1 year ago. Practices with Canton-Potsdam Hospital, a 239-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
1
Licensed in
NY
In the registry since
2025
Specialties on file
2

Practice location Address checks out

77 W Barney St
Gouverneur, NY 13642-1040
Phone: (315) 287-1000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 357031 (NY)
Obstetrics & Gynecology Nurse Practitioner Taxonomy 363LX0001X · Licence 357031 (NY)

Record details

NPI number1518857440
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 3, 2025
Last updated in NPPESJuly 3, 2025
Certification dateJuly 3, 2025
Mailing address50 Leroy St, Potsdam, NY 13676-1786

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Canton-Potsdam Hospital — 239 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare