Individual provider Active NPI

Tatyana Golub, ARNP

  • Nurse Practitioner
  • Palm Harbor, FL
National Provider Identifier
1831641760
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP 9315253 Issued in FL
Practice address
2627 E Ridge Dr
Palm Harbor, FL 34683-2728
Phone
(321) 960-3715
NPI assigned
Oct 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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 ARNP 9315253 FL Primary

Addresses

Primary practice location

2627 E Ridge Dr
Palm Harbor, FL 34683-2728

Mailing address

2627 E Ridge Dr
Palm Harbor, FL 34683-2728
Phone (321) 960-3715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170320002451 FL Practitioner - Nurse Practitioner 7113202813 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP 9315253FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Episource LLC Nurse Practitioner CurrentSince Dec 16, 2020 Accepting new patients
Health & Psychiatrist Consultants LLC CurrentSince Mar 1, 2023 Accepting new patients

Locations

500 W 190th St
Fl 4
Gardena, CA 90248
Phone (424) 292-2923

3919 Tampa Rd
Oldsmar, FL 34677
Phone (727) 733-6111

12332 Race Track Rd
Tampa, FL 33626
Phone (813) 756-4383

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.

NPI Registry JSON

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1831641760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 E RIDGE DR",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346832728",
            "telephone_number": "321-960-3715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 E RIDGE DR",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346832728",
            "telephone_number": "321-960-3715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLUB",
        "first_name": "TATYANA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-26",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP 9315253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

Verify at the official NPI Registry.