Active NPI
Tatiana Brovko, DPT
- Physical Therapist
- Woodland Hills, CA
National Provider Identifier
1194071472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT39230
- Practice address
- 23388 Mulholland Dr
Woodland Hills, CA 91364-2733 - Phone
- (818) 876-1006
- Fax
- (818) 876-1006
- NPI assigned
- Jul 24, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT39230 | CA | Primary |
Addresses
Primary practice location
23388 Mulholland Dr
Woodland Hills, CA 91364-2733
Mailing address
5767 W Century Blvd
Los Angeles, CA 90045-5631
Phone (310) 301-8774
Other practice location 1
719 Santa Monica Blvd
Santa Monica, CA 90401-2601
Phone (310) 260-9039
Other practice location 2
719 Santa Monica Blvd
Santa Monica, CA 90401-2601
Phone (310) 260-9039
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT39230 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| UC Regents | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Los Angeles, CA
- NPI 1982667663
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1194071472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 W CENTURY BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900455631",
"telephone_number": "310-301-8774",
"fax_number": "310-301-8751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23388 MULHOLLAND DR",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913642733",
"telephone_number": "818-876-1006",
"fax_number": "818-876-1006"
}
],
"practiceLocations": [
{
"address_1": "719 Santa Monica Blvd",
"address_purpose": "LOCATION",
"city": "Santa Monica",
"state": "CA",
"postal_code": "904012601",
"country_code": "US",
"telephone_number": "310-260-9039",
"fax_number": "310-260-1091",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "719 Santa Monica Blvd",
"address_purpose": "LOCATION",
"city": "Santa Monica",
"state": "CA",
"postal_code": "904012601",
"country_code": "US",
"telephone_number": "310-260-9039",
"fax_number": "310-260-1091",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BROVKO",
"first_name": "TATIANA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-24",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT39230",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodland Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.