Individual provider Active NPI

Tatyana Maricic

  • Pediatric Registered Nurse
  • Cleveland, OH
National Provider Identifier
1720470909
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
394987 Issued in OH
Practice address
2801 Martin Luther King Jr Dr
Cleveland, OH 44104-3815
Phone
(216) 448-6400
NPI assigned
Feb 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 394987 OH
Pediatric Registered Nurse 163WP0200X 394987 OH Primary

Addresses

Primary practice location

2801 Martin Luther King Jr Dr
Cleveland, OH 44104-3815

Mailing address

6054 Pearl Rd
Parma Heights, OH 44130-2002
Phone (440) 212-6227

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
394987OHMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1720470909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6054 PEARL RD",
            "city": "PARMA HEIGHTS",
            "state": "OH",
            "postal_code": "441302002",
            "telephone_number": "440-212-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 MARTIN LUTHER KING JR DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441043815",
            "telephone_number": "216-448-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARICIC",
        "first_name": "TATYANA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-25",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "OH",
            "license": "394987",
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "OH",
            "license": "394987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; 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.