TYNISHA NICOLE DAVIS FNP-BC
NPI 1760908123
Nurse Practitioner - Family in Philadelphia, PA

Q: What is Tynisha Davis's NPI number?

The NPI number for Tynisha Davis is 1760908123. It was assigned to this individual provider in the NPPES registry on August 17, 2017.

Q: What is Tynisha Davis's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Tynisha Davis was last updated on June 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since August 17, 2017PECOS Enrolled

4190 CITY AVE, PHILADELPHIA, PA 19131(866) 453-8800 Get Directions Write a Review

NPPES record last updated: June 29, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

On this page

About Tynisha Nicole Davis Fnp-bc NPPES

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

TYNISHA NICOLE DAVIS FNP-BC (NPI 1760908123) is an individual family provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (SP017201) and active in the NPI registry since August 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1760908123

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameTYNISHA NICOLE DAVISCredential: FNP-BC

Location Address4190 CITY AVEPhiladelphia, PA 19131-1626

Mailing Address1130 Myrtlewood AveHavertown, PA 19083-5203 · (484) 469-1477

Phone(866) 453-8800

Sole ProprietorNo

Enumeration DateAugust 17, 2017

Last NPPES UpdateJune 29, 2026

NPPES CertifiedJune 29, 2026

✔ NPI 1760908123 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Licenses✔ Licensed in PA · SP017201✔ Licensed in MD · R270405✔ Licensed in DC · NP500021798✔ Licensed in CA · 95022950✔ Licensed in VA · 0024182325

4190 CITY AVE, Philadelphia, PA 19131

Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tynisha Nicole Davis Fnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 19131 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

$92.69 typical visit price

range $59.88 – $180.99

Typical copayment $23.17 (range $14.97 – $45.24)

Most-billed visit code 99203

Established Patient

$105.21 typical visit price

range $19.30 – $147.29

Typical copayment $26.30 (range $4.82 – $36.82)

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 20

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

ZEEL HEMANTBHAI PATEL M.B.B.S

Student in an Organized Health Care Education/Training Program