Individual provider Active NPI

Elena Kirilova Taneva-Cholakova, FNP-BC

  • Nurse Practitioner
  • Tamuning, GU
National Provider Identifier
1417628306
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
21NP05 Issued in FL
Practice address
388 Ypao Rd
Tamuning, GU 96913-3701
Phone
(671) 646-8881
NPI assigned
Sep 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 21NP05 FL Primary

Addresses

Primary practice location

388 Ypao Rd
Tamuning, GU 96913-3701

Mailing address

388 Ypao Rd
Tamuning, GU 96913-3701
Phone (671) 646-8881

Other identifiers 1

IdentifierTypeStateIssuer
NOOtherN/A

Other names 1

  • Elena Kirilova Taneva-Cholakova Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220322002064 GU Practitioner - Nurse Practitioner 9335534734 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Todu Guam Foundation, LTD.Group PAC ID 2062884828, 6 clinicians
Takecare Insurance Company IncGroup PAC ID 8325951239, 28 clinicians

Practice addresses (Care Compare)

125 Tun Jesus Crisostomo St
Suite 104
Tamuning, GU 96913-3551
Phone (671) 649-8638

548 S Marine Corps Dr
Tamuning, GU 96913-3539
Phone (671) 646-5825

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
21NP05FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
General Conference Corp of Sda CurrentSince Jan 13, 2011 Accepting new patients
Todu Guam Foundation LTD CurrentSince May 7, 2025 Accepting new patients
Takecare Insurance Company Inc. CurrentSince Apr 10, 2025 Accepting new patients

Locations

125 Tun Jesus Crisostomo St
Ste 104
Tamuning, GU 96913
Phone (671) 649-8638

548 S Marine Corps Dr
Tamuning, GU 96913
Phone (671) 646-5824

Interoperability endpoints

  • Direct secure messaging: elena.taneva@adventistclinic.directbygreenway.com

Organizations & group practices 5

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": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1417628306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 YPAO RD",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133701",
            "telephone_number": "671-646-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 YPAO RD",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133701",
            "telephone_number": "671-646-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANEVA-CHOLAKOVA",
        "first_name": "ELENA",
        "middle_name": "KIRILOVA",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-21",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "21NP05",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N/A",
            "identifier": "NO",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELENA",
            "last_name": "TANEVA-CHOLAKOVA",
            "middle_name": "KIRILOVA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tamuning, GU

Sources for this page

Verify at the official NPI Registry.