Individual provider Active NPI

Tatyanna Michelle Newman

  • Physician Assistant
  • Burbank, CA
National Provider Identifier
1639928971
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA64191 Issued in CA
Practice address
2501 W Burbank Blvd
Burbank, CA 91505-2347
Phone
(818) 856-9535
NPI assigned
May 17, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA64191 CA Primary

Addresses

Primary practice location

2501 W Burbank Blvd
Burbank, CA 91505-2347

Mailing address

2501 W Burbank Blvd
Burbank, CA 91505-2347
Phone (818) 856-9535

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240819003313 CA Practitioner - Physician Assistant 7618415878 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA64191CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
West Coast Wound and Skin Care Inc CurrentSince Sep 13, 2025 Accepting new patients
Regents Univ of Calif Los Angeles PastSince May 19, 2024 Accepting new patients
Compass Palliative Care, Inc PastSince May 19, 2024 Accepting new patients

Locations

2501 W Burbank Blvd
Ste 200
Burbank, CA 91505
Phone (818) 732-8272

1821 E Chapman Ave
Fullerton, CA 92831
Phone (714) 879-7301

3615 E Imperial Hwy
Lynwood, CA 90262
Phone (310) 639-4623

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.

NPI Registry JSON

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

{
    "created_epoch": "1715904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1639928971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 W BURBANK BLVD",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915052347",
            "telephone_number": "818-856-9535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 W BURBANK BLVD",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915052347",
            "telephone_number": "818-856-9535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWMAN",
        "first_name": "TATYANNA",
        "middle_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-17",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.