Tatiana Masyk, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301069338 Issued in MI

Practice address

6480 Rockside Woods Blvd S Ste 330
Independence, OH 44131-2222

Phone

(567) 316-6755

Fax

(216) 238-9526

NPI assigned

Jul 22, 2005

Last updated

Aug 4, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Enrolled in OH

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 Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Promedica Central Corporation of Michigan

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1588624696
  NPD
• Mountain Crest Oh Opco LLC

  dba Divine Rehabilitation and Nursing at Sylvania

  • Skilled Nursing Facility
  • Sylvania, OH
  • NPI 1295397362
  NPD (past)
• Toledo Rehabilitation and Nursing Center LLC

  dba Divine Rehabilitation and Nursing Center at Toledo

  • Skilled Nursing Facility
  • Toledo, OH
  • NPI 1710588124
  NPD (past)
• White Oak Rehabilitation and Nursing at Divine LLC

  • Skilled Nursing Facility
  • Toledo, OH
  • NPI 1790266005
  NPD (past)
• Epmg of Michigan, P.C.

  • Emergency Medicine Physician
  • Livonia, MI
  • NPI 1386688992
  NPD (past)

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1184624934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5705 SUN VALLEY BLVD",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435603745",
            "telephone_number": "517-403-6857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6480 ROCKSIDE WOODS BLVD S STE 330",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312222",
            "telephone_number": "567-316-6755",
            "fax_number": "216-238-9526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASYK",
        "first_name": "TATIANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-22",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.072419",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301069338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GLHP",
            "identifier": "117183",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "P00343617",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0804610531",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT",
            "identifier": "03605",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2722265",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4917088",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5418586",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPM",
            "identifier": "6088",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000491867",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "117183",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4623463",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shawn Martin, PHARMD
• Marymount Behavioral Health Services
• Marymount Hospital, Inc.
• Marymount Primary Care Services, Inc
• Marymount Primary Care Services, Inc.
• Kudzai Matemachani, SWT
• Christopher Daniel Matthews, LSW
• Dana Y Matthews, PHD., LPCC-S, NCC
• Hannah Mattix, APRN-CNP, RN
• Tywuan Mauldin

• Family Medicine Physician in Independence, OH
• Providers in Independence, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; 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.