Individual provider Active NPI

Tatyana Korableva, PA-C

  • Physician Assistant
  • Saint Petersburg, FL
National Provider Identifier
1912272113
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9106401 Issued in FL
Practice address
710 94TH Ave N Ste 307
Saint Petersburg, FL 33702-2452
Phone
(727) 290-1444
Fax
(813) 661-3374
NPI assigned
Mar 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9106401 FL
Physician Assistant 363A00000X PA9106401 FL Primary

Addresses

Primary practice location

710 94TH Ave N Ste 307
Saint Petersburg, FL 33702-2452

Mailing address

PO Box 1192
Brandon, FL 33509-1192
Phone (813) 651-4441

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
I20120416000610 FL Practitioner - Physician Assistant 5890956007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Bay Area Arthritis and Rheumatology Associates PLLCGroup PAC ID 5698205177, 3 clinicians

Practice addresses (Care Compare)

710 94TH Ave N
Suite 307
Saint Petersburg, FL 33702-2452
Phone (727) 290-1444

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9106401FLMDPhysician Assistant

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: tatyana.korableva.p60@direct.aara1.nextgenshare.com

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.

Hospital & facility affiliations 4

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": "1332288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1912272113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1192",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335091192",
            "telephone_number": "813-651-4441",
            "fax_number": "813-661-3374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 94TH AVE N STE 307",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337022452",
            "telephone_number": "727-290-1444",
            "fax_number": "813-661-3374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORABLEVA",
        "first_name": "TATYANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-21",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9106401",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

Verify at the official NPI Registry.