TYNISE LA'SHAIE PENN (N.P.) – Nurse Practitioner, NPI 1073841011
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,106 NURSE PRACTITIONER in MI
Provider Addresses for TYNISE LA'SHAIE PENN (N.P.)
29877 TELEGRAPH RD STE 401
SOUTHFIELD, MI 480347661
Phone: (248) 294-0539
Fax: (248) 934-1390
Type: Location
31355 BRETZ DR
WARREN, MI 480935532
Phone: (313) 350-1657
Fax: (248) 934-1390
Type: Mailing
Troy Post Office, 400, Broadway, Downtown, City of Troy, Rensselaer County, New York, 12180, United States
TROY, MI 480991239
Phone: (248) 824-6558
Type: Mailing
1985, Gratiot Boulevard, Marysville, Saint Clair County, Michigan, 48040, United States
SUITE 2A
MARYSVILLE, MI 480402215
Phone: (810) 364-5050
Fax: (810) 364-5688
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $68.
Total Amount is formed as General ($68) + Research ($0) + Ownership ($0) = $68.
Last reported payment date: 2023-11-16 • Largest payer in this snapshot: Alkermes, Inc. ($19).
Total Amount
$68
General + Research + Ownership
Payments
4
Total payment records
General Amount
$68
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Alkermes, Inc. | $19 |
| Takeda Pharmaceuticals U.S.A., Inc. | $18 |
| Otsuka America Pharmaceutical, Inc. | $17 |
| ABBVIE INC. | $14 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-01-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100116000252 | I | Nurse Practitioner | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48034)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Clinical Social Worker | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Clinical Social Worker | MI | |
| Nurse Practitioner | MI | |
| Clinical Social Worker | MI | |
| Clinical Social Worker | MI |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.