Individual provider Active NPI

Tatyana Gurevich, AGNP

  • Adult Health Nurse Practitioner
  • Richardson, TX
National Provider Identifier
1639694680
Registry record updated Aug 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP134761 Issued in TX
Practice address
870 N Coit Rd Ste 2660
Richardson, TX 75080-6215
Phone
(972) 235-2459
NPI assigned
Aug 11, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP134761 TX Primary

Addresses

Primary practice location

870 N Coit Rd Ste 2660
Richardson, TX 75080-6215

Mailing address

9534 Fairmont Dr
Frisco, TX 75035-6037
Phone (972) 679-1074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20181126000498 TX Practitioner - Nurse Practitioner 2668726969 Practice locations: Richardson, TX

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

870 N Coit Rd
Suite 2660
Richardson, TX 75080-6215
Phone (972) 235-2459

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Z1K, PA PastSince Jul 1, 2018 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.

NPI Registry JSON

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

{
    "created_epoch": "1502409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502409600000",
    "number": "1639694680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9534 FAIRMONT DR",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750356037",
            "telephone_number": "972-679-1074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 N COIT RD STE 2660",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750806215",
            "telephone_number": "972-235-2459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUREVICH",
        "first_name": "TATYANA",
        "name_prefix": "Mrs.",
        "credential": "AGNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-11",
        "last_updated": "2017-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP134761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

Verify at the official NPI Registry.