Individual provider Active NPI

Tatyana Kovalevich, OTR

  • Occupational Therapist
  • Laredo, TX
National Provider Identifier
1639774110
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
121350 Issued in TX
Practice address
2335 E Saunders St # III
Laredo, TX 78041-5434
Phone
(956) 791-4804
NPI assigned
Dec 2, 2020
Last updated
Dec 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 121350 TX Primary

Addresses

Primary practice location

2335 E Saunders St # III
Laredo, TX 78041-5434

Mailing address

2335 E Saunders St # III
Laredo, TX 78041-5434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220714002425 FL Practitioner - Occupational Therapist in Private Practice 2860873353 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3701 W McNab Rd
Pompano Beach, FL 33069-4966
Phone (954) 248-3290

5325 Greenwood Ave
Suite 101
West Palm Beach, FL 33407-2452
Phone (561) 844-5255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stellar Therapy Services LLC CurrentSince Apr 11, 2023 Accepting new patients
Tenet Florida Physician Services II, LLC CurrentSince Aug 11, 2025 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Jun 11, 2022 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Jun 11, 2022 Accepting new patients
Tenet Florida Physician Services II, LLC CurrentSince Aug 11, 2025 Accepting new patients

Locations

1000 NE 56th St
Oakland Park, FL 33334
Phone (954) 229-8608

5325 Greenwood Ave
Ste 101
West Palm Beach, FL 33407
Phone (561) 844-7878

5325 Greenwood Ave
Ste 201
West Palm Beach, FL 33407
Phone (561) 422-9603

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, 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": "1606867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1639774110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2335 E SAUNDERS ST # III",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780415434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2335 E SAUNDERS ST # III",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780415434",
            "telephone_number": "956-791-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVALEVICH",
        "first_name": "TATYANA",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-02",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "121350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.