TATJANA MISUNINA (PA-C) – Surgical Physician Assistant, NPI 1053717660
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,322 PHYSICIAN ASSISTANT in NC
Provider Addresses for TATJANA MISUNINA (PA-C)
PO BOX 744786
ATLANTA, GA 303744786
Phone: (410) 245-5367
Type: Mailing
2525 COURT DR STE 200
GASTONIA, NC 280542140
Phone: (410) 245-5367
Type: Location
21 WOODENBRIDGE CT
REISTERSTOWN, MD 211363727
Phone: (410) 245-5367
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 13 Open Payments records for all available years, with a total value of $625.
Total Amount is formed as General ($625) + Research ($0) + Ownership ($0) = $625.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Edwards Lifesciences Corporation ($200).
Total Amount
$625
General + Research + Ownership
Payments
13
Total payment records
General Amount
$625
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-04-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170425000063 | I | Physician Assistant | NC | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30374)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Hospitalist, Internal Medicine | NC | |
| Cardiovascular Disease (Cardiology), Interventional Cardiology | NC | |
| Internal Medicine | NC | |
| Internal Medicine | NC | |
| - | NC | |
| Nurse Practitioner | NC | |
| Hospitalist, Internal Medicine | NJ | |
| Nurse Practitioner | NC | |
| - | NC | |
| G A S T R O E N T E R O L O G Y | NC |
Reviews
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