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TANYA LYNN PETACCIO CRNP
NPI 1740172253
Nurse Practitioner - Psychiatric/Mental Health in Lehighton, PA

Active since July 18, 2025PECOS Enrolled
1290 BLAKESLEE BOULEVARD DR W STE 1, LEHIGHTON, PA 18235(484) 934-1155(484) 727-9991 Get Directions Write a Review

NPPES record last updated: July 18, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Tanya Lynn Petaccio Crnp NPPES

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

TANYA LYNN PETACCIO CRNP (NPI 1740172253) is an individual psychiatric/mental health provider in Lehighton, Pennsylvania, licensed in Pennsylvania (SPO33194) and active in the NPI registry since July 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1740172253
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameTANYA LYNN PETACCIOCredential: CRNP
Location Address1290 BLAKESLEE BOULEVARD DR W STE 1Lehighton, PA 18235-9352
Mailing Address1290 Blakeslee Boulevard Dr W Ste 1Lehighton, PA 18235-9352 · (484) 934-1155 · Fax (484) 727-9991
Phone(484) 934-1155
Fax(484) 727-9991
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateJuly 18, 2025
NPPES CertifiedJuly 18, 2025
✔ NPI 1740172253 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in PA · SPO33194
1290 BLAKESLEE BOULEVARD DR W STE 1, Lehighton, PA 18235
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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 (PECOS)

Tanya Lynn Petaccio Crnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8729589981
PECOS Enrollment IDI20250828004288
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18235 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

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

MR. FRANK GOLDEN CRNP
Nurse Practitioner (Psychiatric/Mental Health)
1290 BLAKESLEE BOULEVARD DR W STE 1
LEHIGHTON, PA 18235
Carbon County (484) 934-1155
942 PSYCHIATRIC SERVICES
Nurse Practitioner (Psychiatric/Mental Health)
1290 BLAKESLEE BOULEVARD DR W STE 1
LEHIGHTON, PA 18235
Carbon County (484) 934-1155

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tanya Petaccio's NPI number?

The NPI number for Tanya Petaccio is 1740172253. It was assigned to this individual provider in the NPPES registry on July 18, 2025.

Where is Tanya Petaccio located?

Tanya Petaccio practices at 1290 Blakeslee Boulevard Dr W Ste 1, Lehighton, PA 18235. The listed phone number is (484) 934-1155.

What is Tanya Petaccio's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Tanya Petaccio enrolled in Medicare?

Yes. Tanya Petaccio is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Tanya Petaccio was last updated on July 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.