Tiffany A Robak, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO2022-0143 Issued in NM

Practice address

505 Camino de Los Marquez
Santa Fe, NM 87505-1837

Phone

(505) 405-8423

Fax

(505) 485-0641

NPI assigned

Mar 22, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NM, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Osteopathic Manipulative Medicine

Education

Rocky Vista University College of Osteopathic Med, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Non-Surgical Orthopedic Center a Professional Medical CorporationGroup PAC ID 7315168820, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Traditional American Osteopathy, LLC

  • Family Medicine Physician
  • Santa Fe, NM
  • NPI 1659138832

  Single Specialty

  Medicare reassignment NPD Authorized official
• Non-Surgical Orthopedic Center a Professional Medical Corporation

  • Specialist
  • Oceanside, CA
  • NPI 1164847547

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Memorial Health Systems Inc

  • Surgery Physician
  • Daytona Beach, FL
  • NPI 1922115914

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1003376203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 ZAFARANO DR STE C PMB 249",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "87507",
            "telephone_number": "505-405-8423",
            "fax_number": "505-485-0641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 CAMINO DE LOS MARQUEZ",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875051837",
            "telephone_number": "505-405-8423",
            "fax_number": "505-485-0641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7975 Lake Underhill Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328228204",
            "country_code": "US",
            "telephone_number": "407-303-8683",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1775 Ballard Rd",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600681005",
            "country_code": "US",
            "telephone_number": "847-318-6020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBAK",
        "first_name": "TIFFANY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-22",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "DO2022-0143",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IL",
            "license": "125.075065",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariah Selena Rivera
• Mauro I Rivera, LMT, RMTI
• Susan C Rivera, BMS
• Toni Luisa Rivera, D.C.
• Theresa Dec Roach, MS, NCC
• Eleanor Frances Robbins, MSW LISW LCSW
• Emily Robbins, CCC-SLP
• Monica Jean Robbins, LMSW
• Robert a McCormick MD LTD
• Robert Kevin Hennelly, LPPC, LLC

• Family Medicine Physician in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.