Tetyana McIlvaine, DO

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

DOS1935 Issued in HI

Practice address

9177 Ridgetop Blvd NW
Silverdale, WA 98383-8519

Phone

(360) 307-6961

NPI assigned

May 2, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tetyana Tsebro Former name

Medicare fee-for-service enrollment

Enrolled in HI

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1493683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1033645684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9177 RIDGETOP BLVD NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838519",
            "telephone_number": "360-307-6961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9177 RIDGETOP BLVD NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838519",
            "telephone_number": "360-307-6961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCILVAINE",
        "first_name": "TETYANA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-02",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "HI",
            "license": "DOS1935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TETYANA",
            "last_name": "TSEBRO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Richard McDowell
• Gary Patrick McFarland, PT
• Barbara McGinley, CCC-SLP
• Loretta Lee McGinley, MHC
• Ann Louise McIlrath, LMP
• Jennifer McKee, NBC-HWC
• Shannon H McKee, MSW
• Andrea McKenzie
• Kyle McKenzie, D.C.
• Luke Daniel McKinney

• Geriatric Medicine (Internal Medicine) Physician in Silverdale, WA
• Providers in Silverdale, WA by specialty
• Geriatric Medicine (Internal Medicine) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.