TYANA RAYNOR D.O.
NPI 1346687811
Student in an Organized Health Care Education/Training Program in Riverhead, NY

Q: What is Tyana Raynor's NPI number?

The NPI number for Tyana Raynor is 1346687811. It was assigned to this individual provider in the NPPES registry on May 23, 2013.

Q: What is Tyana Raynor's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Tyana Raynor was last updated on September 28, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 23, 2013PECOS EnrolledAccepts Medicare Assignment

1300 ROANOKE AVE, RIVERHEAD, NY 11901(631) 548-6446(631) 727-0772 Get Directions Write a Review

NPPES record last updated: September 28, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Tyana Raynor D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TYANA RAYNOR D.O. (NPI 1346687811) is an individual student in an organized health care education/training program in Riverhead, New York and active in the NPI registry since May 2013. She is enrolled in Medicare PECOS and is a graduate of Philadelphia College Of Osteopathic Medicine (2013).

NPPES Registry Identity

NPI1346687811

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameTYANA RAYNORCredential: D.O.

Location Address1300 ROANOKE AVERiverhead, NY 11901-2031

Mailing Address1000 Montauk HwyWest Islip, NY 11795-4927

Phone(631) 548-6446

Fax(631) 727-0772

Sole ProprietorNo

Medical School CMSPhiladelphia College Of Osteopathic MedicineGraduated 2013

Enumeration DateMay 23, 2013

Last NPPES UpdateSeptember 28, 2023

NPPES CertifiedSeptember 28, 2023

✔ NPI 1346687811 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also ListedRadiology · Pediatric RadiologyTaxonomy 2085P0229X · License OS18820 (FL)

Also ListedRadiology · Diagnostic RadiologyTaxonomy 2085R0202X · License 05370 (KY)

1300 ROANOKE AVE, Riverhead, NY 11901

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tyana Raynor D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3870962863

PECOS Enrollment IDI20221214001477, I20221227000625

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. CHRISTOPHER MICHAEL HART RPAC

Physician Assistant (Medical)