NPIMap

Individual provider Active NPI

Tatyana Borodulin, M.D.

  • Family Medicine Physician
  • Campbell, CA
National Provider Identifier
1912940628
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Practice address
1600 W Campbell Ave
Campbell, CA 95008-1526
Phone
(408) 378-3300
Fax
(408) 378-6822
NPI assigned
Jun 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X CA Primary

Addresses

Primary practice location

1600 W Campbell Ave
Campbell, CA 95008-1526

Mailing address

1600 W Campbell Ave
Campbell, CA 95008-1526
Phone (408) 378-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070904000351 CA Practitioner - Family Practice 9537252705 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1600 W Campbell Ave
Suite 202
Campbell, CA 95008-1526
Phone (408) 378-3300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Tatyana V. Borodulin MD, Inc Family Medicine CurrentSince May 1, 2002 Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients

Locations

1600 W Campbell Ave
Ste 202
Campbell, CA 95008
Phone (408) 378-3300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GFGBBA/Endpoint/GFGBBA

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 11

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1912940628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W CAMPBELL AVE",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950081526",
            "telephone_number": "408-378-3300",
            "fax_number": "408-378-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W CAMPBELL AVE",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950081526",
            "telephone_number": "408-378-3300",
            "fax_number": "408-378-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORODULIN",
        "first_name": "TATYANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

Verify at the official NPI Registry.