Individual provider Active NPI

Maryna Tarasenko, NP

  • Nurse Practitioner
  • Santa Barbara, CA
National Provider Identifier
1730837659
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95020222 Issued in CA
Practice address
400 W Pueblo St
Santa Barbara, CA 93105-4353
Phone
(805) 682-7111
NPI assigned
Mar 10, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X 95020222 CA Primary

Addresses

Primary practice location

400 W Pueblo St
Santa Barbara, CA 93105-4353

Mailing address

1432 Santa Fe LN
Santa Barbara, CA 93109-2399
Phone (805) 722-8568

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
I20220823001725 CA Practitioner - Nurse Practitioner 2466835541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Neurology PCGroup PAC ID 3971871500, 60 clinicians

Practice addresses (Care Compare)

400 W Pueblo St
Santa Barbara, CA 93105-4353
Phone (805) 682-7111

Hospital & facility affiliations

  • Santa Barbara Cottage Hospital Hospital, Santa Barbara, CA, CCN 050396

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95020222CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Neurology PC Multi-Specialty CurrentSince Sep 1, 2022 Accepting new patients
Cep America - Neurology PC Multi-Specialty CurrentSince Sep 1, 2022 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

400 W Pueblo St
Santa Barbara, CA 93105
Phone (805) 569-7279

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1646870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1730837659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1432 SANTA FE LN",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931092399",
            "telephone_number": "805-722-8568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W PUEBLO ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931054353",
            "telephone_number": "805-682-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARASENKO",
        "first_name": "MARYNA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-10",
        "last_updated": "2022-03-10",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95020222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.