Active NPI
Tatiana Gandrabura, M.D
- Endocrinology, Diabetes & Metabolism Physician
- Moorestown, NJ
National Provider Identifier
1861602740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- 25MA09181800
- Practice address
- 401 Young Ave Ste 245B
Moorestown, NJ 08057-3132 - Phone
- (856) 727-0900
- Fax
- (856) 231-8428
- NPI assigned
- May 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 25MA09181800 | NJ | |
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 25MA09181800 | NJ | Primary |
Addresses
Primary practice location
401 Young Ave Ste 245B
Moorestown, NJ 08057-3132
Mailing address
1015 Briggs Rd Ste 200
Mount Laurel, NJ 08054-4114
Phone (856) 727-0900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0346292 | Medicaid | NJ |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tgandrabura13425@directvirtua.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Endocrinology
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
175 Madison Ave
Mount Holly, NJ 08060-2038
218 Sunset Rd
FL 5
Willingboro, NJ 08046-1110
Phone (609) 444-0359
3242 Route 206
Bordentown, NJ 08505-4517
Hospital & facility affiliations
- Virtua Mount Holly Hospital
- Virtua Willingboro Hospital
- Cooper University Hospital
- West Jersey Hospital
- Virtua Our Lady of Lourdes Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.15 of 100
- Quality
- 62.28
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.89
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
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.
-
- Family Medicine Physician
- Marlton, NJ
- NPI 1649226515
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Camden, NJ
- NPI 1568442309
-
- General Acute Care Hospital
- Mount Holly, NJ
- NPI 1134125016
-
- General Acute Care Hospital
- Voorhees, NJ
- NPI 1528064409
-
- General Acute Care Hospital
- Camden, NJ
- NPI 1235134024
-
- General Acute Care Hospital
- Willingboro, NJ
- NPI 1053316844
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739923200000",
"number": "1861602740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 BRIGGS RD STE 200",
"city": "MOUNT LAUREL",
"state": "NJ",
"postal_code": "080544114",
"telephone_number": "856-727-0900",
"fax_number": "856-231-8428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 YOUNG AVE STE 245B",
"city": "MOORESTOWN",
"state": "NJ",
"postal_code": "080573132",
"telephone_number": "856-727-0900",
"fax_number": "856-231-8428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANDRABURA",
"first_name": "TATIANA",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2025-02-19",
"certification_date": "2025-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NJ",
"license": "25MA09181800",
"primary": false
},
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "NJ",
"license": "25MA09181800",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0346292",
"state": "NJ"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tgandrabura13425@directvirtua.org",
"affiliation": "N",
"address_1": "401 Young Ave Ste 245B",
"city": "Moorestown",
"state": "NJ",
"country_code": "US",
"postal_code": "080573132",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Moorestown, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.