NPIMap

Individual provider Active NPI

Philomela Martirez Tabuena, MD

  • Family Medicine Physician
  • Martinsburg, WV
National Provider Identifier
1467659102
Registry record updated Mar 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23821 Issued in WV
Practice address
1004 Tavern Rd
Martinsburg, WV 25401-2864
Phone
(304) 264-4433
Fax
(304) 264-4446
NPI assigned
Jun 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 23821 WV Primary

Addresses

Primary practice location

1004 Tavern Rd
Martinsburg, WV 25401-2864

Mailing address

220 Campus Blvd
Ste 200
Winchester, VA 22601-2889
Phone (540) 536-5100

Other practice location 1

116 E 3rd Ave
Ranson, WV 25438-1641
Phone (304) 724-7200

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address ptabuena513903@soc.inova.org
Direct Messaging Address ptabuena513903@soc.inova.org
Direct Messaging Address ptabuena513903@soc.inova.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091026000042 WV Practitioner - Family Practice 8729125760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Oak Lee Dr
Ranson, WV 25438-4879
Phone (304) 930-0001

240 Joshua M Freeman Blvd
Ranson, WV 25438-5759
Phone (304) 724-7200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
East Mountain Health Physicians, Inc. CurrentSince Sep 11, 2018 Accepting new patients
East Mountain Health Physicians, Inc. Family Medicine CurrentSince Sep 11, 2018 Accepting new patients
East Mountain Health Physicians Inc. Family Medicine Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
East Mountain Health Physicians, Inc. Past Accepting new patients

Locations

220 Campus Blvd
Ste 200
Winchester, VA 22601
Phone (540) 536-0307

1004 Sushruta Dr
Ste D
Martinsburg, WV 25401
Phone (304) 262-2538

1004 Tavern Rd
Martinsburg, WV 25401
Phone (304) 264-4433

1000 Tavern Rd
Ste 100
Martinsburg, WV 25401
Phone (304) 267-9355

101 Marcley Dr
Martinsburg, WV 25401
Phone (304) 263-8911

100 Oak Lee Dr
Ranson, WV 25438
Phone (304) 350-0001

116 E 3rd Ave
Ranson, WV 25438
Phone (304) 724-7200

Interoperability endpoints

  • Direct secure messaging: ptabuena513903@soc.inova.org
  • Direct secure messaging: ptabuena513903@valleyhealth.direct-ci.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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615075200000",
    "number": "1467659102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CAMPUS BLVD",
            "address_2": "STE 200",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012889",
            "telephone_number": "540-536-5100",
            "fax_number": "540-536-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 TAVERN RD",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254012864",
            "telephone_number": "304-264-4433",
            "fax_number": "304-264-4446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "116 E 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Ranson",
            "state": "WV",
            "postal_code": "254381641",
            "country_code": "US",
            "telephone_number": "304-724-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TABUENA",
        "first_name": "PHILOMELA",
        "middle_name": "MARTIREZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2021-03-07",
        "certification_date": "2021-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "23821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ptabuena513903@soc.inova.org",
            "affiliation": "N",
            "address_1": "116 E 3rd Ave",
            "city": "Ranson",
            "state": "WV",
            "country_code": "US",
            "postal_code": "254381641",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ptabuena513903@soc.inova.org",
            "affiliation": "N",
            "address_1": "1000 Tavern Rd Ste 100",
            "city": "Martinsburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "254012853",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ptabuena513903@soc.inova.org",
            "affiliation": "N",
            "address_1": "101 Marcley Dr",
            "city": "Martinsburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "254012977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

Verify at the official NPI Registry.