Individual provider Active NPI

Tatyana Vladimirovna Valentin, AGACNP

  • Nurse Practitioner
  • Easton, MD
National Provider Identifier
1659986735
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R211661 Issued in MD
Practice address
490 Cadmus LN Ste 102
Easton, MD 21601-4091
Phone
(410) 770-5250
NPI assigned
Sep 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R211661 MD Primary

Addresses

Primary practice location

490 Cadmus LN Ste 102
Easton, MD 21601-4091

Mailing address

7486 Tour Dr
Easton, MD 21601-8109
Phone (443) 786-3384

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20201208002820 MD Practitioner - Nurse Practitioner 5092127498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

490 Cadmus LN
Suite 102
Easton, MD 21601-4091
Phone (410) 822-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R211661MDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Community Medical Group, Inc. CurrentSince Dec 7, 2020 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Dec 7, 2020 Accepting new patients

Locations

400 Byrn St
Apt B
Cambridge, MD 21613
Phone (410) 221-0448

2540 Centreville Rd
Centreville, MD 21617
Phone (410) 758-4432

100 Brown St
Chestertown, MD 21620
Phone (410) 778-3300

219 S Washington St
Easton, MD 21601

490 Cadmus Ln
Ste 102
Easton, MD 21601
Phone (410) 770-5250

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

900 Elkridge Landing Rd
Fl 2
Linthicum Heights, MD 21090
Phone (443) 462-5010

125 Shoreway Dr
Ste 210
Queenstown, MD 21658
Phone (410) 770-5250

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1659986735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7486 TOUR DR",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216018109",
            "telephone_number": "443-786-3384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 CADMUS LN STE 102",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216014091",
            "telephone_number": "410-770-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENTIN",
        "first_name": "TATYANA",
        "middle_name": "VLADIMIROVNA",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-15",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R211661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, MD

Sources for this page

Verify at the official NPI Registry.