Individual provider Active NPI

Tatianna Krastev

  • Behavior Technician
  • Berlin, MD
National Provider Identifier
1790255693
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
10514 Racetrack Rd Ste G
Berlin, MD 21811-3241
Phone
(410) 973-2301
NPI assigned
Dec 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X MD Primary

Addresses

Primary practice location

10514 Racetrack Rd Ste G
Berlin, MD 21811-3241

Mailing address

10514 Racetrack Rd Ste G
Berlin, MD 21811-3241
Phone (410) 973-2301

Other identifiers 1

IdentifierTypeStateIssuer
483106300MedicaidMD

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean Front Counseling Past Accepting new patients

Organizations & group practices 1

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": "1543881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1790255693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10514 RACETRACK RD STE G",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218113241",
            "telephone_number": "410-973-2301",
            "fax_number": "410-973-2305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10514 RACETRACK RD STE G",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218113241",
            "telephone_number": "410-973-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRASTEV",
        "first_name": "TATIANNA",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-04",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "483106300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.