Individual provider Active NPI

Tatjana Amarus Muwwakkil, CNM, WHNP-BC

  • Midwife
  • Los Angeles, CA
National Provider Identifier
1568162865
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
Practice address
695 S Santa Fe Ave Apt 611
Los Angeles, CA 90021-1364
Phone
(215) 913-9768
NPI assigned
Mar 6, 2023
Last updated
Mar 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X Primary

Addresses

Primary practice location

695 S Santa Fe Ave Apt 611
Los Angeles, CA 90021-1364

Mailing address

695 S Santa Fe Ave Apt 611
Los Angeles, CA 90021-1364
Phone (215) 913-9768

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260424001536 CA Practitioner - Certified Nurse Midwife (CNM) 4082062138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

777 Lawndres Hill Rd
Greenville, SC 29607-2101

777 Lowndes Hill Rd
BLDG 1
Greenville, SC 29607-2131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

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

NPI Registry JSON

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1568162865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 S SANTA FE AVE APT 611",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900211364",
            "telephone_number": "215-913-9768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 S SANTA FE AVE APT 611",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900211364",
            "telephone_number": "215-913-9768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUWWAKKIL",
        "first_name": "TATJANA",
        "middle_name": "AMARUS",
        "credential": "CNM, WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.