Individual provider Active NPI

Tatyana Budarina, OD

  • Optometrist
  • San Diego, CA
National Provider Identifier
1619526639
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34342TLG Issued in CA
Practice address
3075 Health Center Dr Ste 403
San Diego, CA 92123-2773
Phone
(858) 278-9900
NPI assigned
Sep 11, 2019
Last updated
Oct 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34342TLG CA Primary
Corneal and Contact Management Optometrist 152WC0802X 34342TLG CA

Addresses

Primary practice location

3075 Health Center Dr Ste 403
San Diego, CA 92123-2773

Mailing address

10635 Calle Mar de Mariposa
San Diego, CA 92130-8679
Phone (626) 375-2125

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

LicenseStateTypeSpecialty
34342TLGCAMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecare Solutions Inc CurrentSince Nov 27, 2022 Accepting new patients
Manell & Cooper Optometrist Optometrist PastSince Nov 1, 2019 Accepting new patients

Locations

477 N El Camino Real
Ste C202
Encinitas, CA 92024
Phone (760) 631-3500

Interoperability endpoints

  • Direct secure messaging: tbudarina@nceyecenter.eyefinity-direct.com

Organizations & group practices 2

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": "1568160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1619526639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10635 CALLE MAR DE MARIPOSA",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921308679",
            "telephone_number": "626-375-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 HEALTH CENTER DR STE 403",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232773",
            "telephone_number": "858-278-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUDARINA",
        "first_name": "TATYANA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-11",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34342TLG",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "34342TLG",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.