MS. TANJA NUNNOLD (P.A.) – Medical Physician Assistant, NPI 1578573432

MS. TANJA NUNNOLD (P.A.) is a healthcare provider. based in Virginia beach, Virginia. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials P.A.. They hold a License No. 0110002120 (VA). The NPI Number for MS. TANJA NUNNOLD (P.A.) is 1578573432

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
MS. TANJA NUNNOLD (P.A.)
NPI
1578573432
Phone
(757) 490-6637
Address
291 INDEPENDENCE BLVD
Enumeration Date
9 August 2006
Last Update Date
17 June 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7578388030
Graduation Year
2005 (21 years ago)
PAC ID
0042235160
Group Practice PAC ID
7012071608
Professional Enrollment ID
I20051007000684
Address ID
VA236665843HA17XXXSQXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

4,430 PHYSICIAN ASSISTANT in VA

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Provider Addresses for MS. TANJA NUNNOLD (P.A.)

  • Building 4, 291, Independence Boulevard, Virginia Beach, Virginia, 23462, United States

    PEMBROKE BLDG 4 STE 522

    VIRGINIA BEACH, VA 23462

    Phone: (757) 490-6637

    Fax: (757) 490-6636

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 36 Open Payments records for all available years, with a total value of $1,415.

Total Amount is formed as General ($1,415) + Research ($0) + Ownership ($0) = $1,415.

Last reported payment date: 2024-12-04 • Largest payer in this snapshot: ABBVIE INC. ($526).

Total Amount

$1,415

General + Research + Ownership

Payments

36

Total payment records

General Amount

$1,415

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-04

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2005-10-07

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20051007000684IPhysician AssistantVATBD

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.

Verify on CMS Revalidation Lookup Tool

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 23462)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7012071608View full group profile
NameSpecialtyState
D E R M A T O L O G YCA
-VA
Physician AssistantVA
D E R M A T O L O G YVA
Physician AssistantVA
-FL
D E R M A T O L O G YVA
D E R M A T O L O G YTX
D E R M A T O L O G YNC

Reviews

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Frequently asked questions

What NPI should I save for MS. TANJA NUNNOLD (P.A.)?
Save NPI 1578573432 if you need a stable reference for MS. TANJA NUNNOLD (P.A.).
Does this profile mean MS. TANJA NUNNOLD (P.A.) is currently active?
Yes — MS. TANJA NUNNOLD (P.A.) appears active in the national provider directory.
What field does MS. TANJA NUNNOLD (P.A.) work in?
You can think of MS. TANJA NUNNOLD (P.A.) as practicing within Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
What location shows for MS. TANJA NUNNOLD (P.A.)?
We surface Virginia Beach, Virginia for MS. TANJA NUNNOLD (P.A.) based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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