TATIANA VLADIMIROVNA (D.O.) – Emergency Medicine Physician, NPI 1639516495

TATIANA VLADIMIROVNA (D.O.) is a healthcare provider. based in Atlanta, Georgia. specializing in EMERGENCY MEDICINE. They hold the professional credentials D.O.. They hold a License No. DO-55400 (IA). The NPI Number for TATIANA VLADIMIROVNA (D.O.) is 1639516495

Main info

Female
Sole Proprietor
13 Years Of Experience
Accepts Medicare Assignment
Name
TATIANA VLADIMIROVNA (D.O.)
NPI
1639516495
Phone
(757) 651-3612
Address
1364 CLIFTON RD NE
Enumeration Date
3 June 2013
Last Update Date
13 October 2025

Doctor Profile

Medical School Name
EDWARD VIA COL OF OSTEO MEDICINE-VIRGINIA CAMPUS
Secondary Phone
5634211000
Graduation Year
2013 (13 years ago)
PAC ID
6800190174
Group Practice PAC ID
3476909409
Professional Enrollment ID
I20250925000441
Address ID
IA528032459DA1227XSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness85
Years active:13State licenses:2Digital endpointsOther names

1,513 EMERGENCY MEDICINE in GA

Provider Addresses for TATIANA VLADIMIROVNA (D.O.)

  • 1364 CLIFTON RD NE

    ATLANTA, GA 303221059

    Phone: (757) 651-3612

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-09-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160811001326IEmergency MedicineGATBD
I20250925000441IEmergency MedicineIATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making188183$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only109106$0
99284Emergency department visit with moderate level of medical decision making7069$0
99291Critical care, first 30-74 minutes6767$0
View full utilization report →

Insurance plans in this area (ZIP 30322)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3476909409View full group profile
NameSpecialtyState
Emergency MedicineIA
Emergency MedicineOH
Emergency MedicineOH
Emergency MedicineMI
Emergency MedicineNJ
Emergency Medicine, Family PracticeIA
Emergency MedicineMI
Emergency MedicineOH
Emergency MedicineIL
Emergency MedicineCA

Reviews

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Frequently asked questions

What NPI should I save for TATIANA VLADIMIROVNA (D.O.)?
Save NPI 1639516495 if you need a stable reference for TATIANA VLADIMIROVNA (D.O.).
Is TATIANA VLADIMIROVNA (D.O.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does TATIANA VLADIMIROVNA (D.O.) list a primary specialty?
If you are matching referrals, note Emergency Medicine Physician for TATIANA VLADIMIROVNA (D.O.). Clinical services aligned with this taxonomy classification.
Where does public data place TATIANA VLADIMIROVNA (D.O.)?
The snapshot lists Atlanta, Georgia for TATIANA VLADIMIROVNA (D.O.); download NPPES for the complete set.
What if Atlanta, Georgia seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.