Individual provider Active NPI

Tamika Patilla, MD

  • Pediatrics Physician
  • Medina, OH
National Provider Identifier
1033324017
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
34.093202 Issued in OH
Practice address
3443 Medina Rd
Suite 115
Medina, OH 44256-5360
Phone
(330) 764-3457
Fax
(330) 764-3464
NPI assigned
May 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 34.093202 OH Primary

Addresses

Primary practice location

3443 Medina Rd
Suite 115
Medina, OH 44256-5360

Mailing address

1 Perkins SQ
Akron, OH 44308-1063
Phone (330) 764-3457

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tpatilla13024@direct.chmca.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34.093202OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Akron Children'S Hospital Current Accepting new patients
Children'S Hospital Medical Center of Akron Pediatrics Past Accepting new patients
Children'S Hospital Medical Center of Akron Past Accepting new patients

Locations

1 Perkins Sq
Akron, OH 44308
Phone (330) 543-8050

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1033324017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PERKINS SQ",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081063",
            "telephone_number": "330-764-3457",
            "fax_number": "330-764-3464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3443 MEDINA RD",
            "address_2": "SUITE 115",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565360",
            "telephone_number": "330-764-3457",
            "fax_number": "330-764-3464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATILLA",
        "first_name": "TAMIKA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "34.093202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tpatilla13024@direct.chmca.org",
            "affiliation": "N",
            "address_1": "3443 Medina Rd",
            "address_2": "Suite 115",
            "city": "Medina",
            "state": "OH",
            "country_code": "US",
            "postal_code": "442565360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.