TATIANA MASYK (NPI# 1184624934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184624934 |
| Entity Type | Individual |
| Full Name | TATIANA MASYK |
| Credential | MD |
| Practice Address |
901 Kimole Ln Suite A-4 Adrian MI 49221-1491 |
| Mailing Address |
7559 Club Rd Sylvania OH 43560-3722 |
| Practice Telephone | 5172636140 |
| Practice Fax Number | 5172655876 |
| Mailing Telephone | 4198850291 |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2012-01-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 35.072419 | OH | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 4301069338 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4623463 | 05 | |
| AETNA | 5418586 | 01 | |
| ANTHEM | 000000491867 | 01 | |
| OH | 2722265 | 05 | |
| HPM | 6088 | 01 | |
| MI | PARAMOUNT | 03605 | 01 |
| MI | BCBS | 0804610531 | 01 |
| MI | CARE CHOICES | 117183 | 01 |
| GLHP | 117183 | 01 | |
| MI | 4917088 | 05 | |
| RRMC | P00343617 | 01 |
| Street Address |
901 KIMOLE LN SUITE A-4 |
| City | ADRIAN |
| State | MI |
| Zip Code | 49221-1491 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841535762 | Ryan Knape | Physician Assistant | 901 Kimole Ln, Suite A-4, Adrian, MI 49221-1491 | 2012-12-04 |
| 1548540610 | Monica Jane Lutz | Physician Assistant | 901 Kimole Ln, B-1, Adrian, MI 49221-1491 | 2011-08-22 |
| 1003066440 | Adekoyejo B Adenuga | Pediatrics | 901 Kimole Ln, Suite B2, Adrian, MI 49221-1491 | 2008-09-23 |
| 1891953352 | Melissa Marie Baer | Obstetrics & Gynecology | 901 Kimole Ln, Suite A-1, Adrian, MI 49221-1491 | 2008-05-30 |
| 1841419421 | Victor Joseph Cherfan Jr. | Obstetrics & Gynecology | 901 Kimole Ln, Suite A-1, Adrian, MI 49221-1491 | 2007-04-24 |
| 1154548592 | Promedica Corporation of Michigan | Obstetrics & Gynecology | 901 Kimole Ln, Suite A-1, Adrian, MI 49221-1491 | 2007-04-19 |
| 1568581148 | Elizabeth J Szynkowski | Dietitian, Registered | 901 Kimole Ln, Suite A-4, Adrian, MI 49221-1491 | 2007-03-28 |
| 1841322286 | Steven M Smolinski | Obstetrics & Gynecology | 901 Kimole Ln, Suite A-1, Adrian, MI 49221-1491 | 2007-03-12 |
| 1477689859 | Promedica Corporation of Michigan | Family Medicine | 901 Kimole Ln, Suite A-4, Adrian, MI 49221-1491 | 2007-02-27 |
| 1669508404 | Louise Anne Justus | Physician Assistant | 901 Kimole Ln, Adrian, MI 49221-1491 | 2007-02-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285116723 | Sandra Ann Harsh | Occupational Therapist | Total Rehab, 1136 Country Club, Adrian, MI 49221 | 2018-08-31 |
| 1588156178 | Chelsea Varney | Social Worker | 1040 Winter Street, Adrian, MI 49221 | 2018-05-31 |
| 1669974127 | Nicoletta Mary Bruno | Physical Therapy Assistant | 700 Lakeshire Trail, Adrian, MI 49221 | 2018-03-01 |
| 1871011403 | Evan Splan | Pharmacist | 1200 South Main St Suite A, Adrian, MI 49221 | 2017-09-04 |
| 1780104992 | Daniel Malcolm | Specialist/Technologist | 1325 Williams St., Adrian, MI 49221 | 2017-06-20 |
| 1639602881 | Robert Gargol | Pharmacist | 1535 W Maumee, Adrian, MI 49221 | 2017-04-05 |
| 1487196416 | Painless Dentistry V | Dentist | 160 N. Winter St., Adrian, MI 49221 | 2016-11-08 |
| 1487025227 | Michelle Lynn Ranta | Speech-Language Pathologist | 730 Kimole Ln., Adrian, MI 49221 | 2015-10-19 |
| 1376929109 | James Hamblin | Technician, Other | 1100 South Main St. Lot 139, Adrian, MI 49221 | 2015-08-04 |
| 1316320039 | Shirley Goodlock | Community/Behavioral Health | 3091 E. Carleton Rd, Adrian, MI 49221 | 2015-06-30 |
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| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265720262 | Aron Alan Gornowicz | Family Medicine | 146 South Charles Street, Adrian, MI 49221 | 2011-07-12 |
| 1235157421 | Tariq A. Siddiqi | Family Medicine | 755 High St, Adrian, MI 49221-1442 | 2006-07-17 |
| 1598729535 | Amy Patton | Family Medicine | 3245 N Adrian Hwy Ste A, Adrian, MI 49221 | 2006-04-14 |
| 1205830791 | Nathan P Rud | Family Medicine | 601 Louisiana Ave, Adrian, MN 56110-1051 | 2005-06-13 |
| 1306206578 | Indigo Hospital Medicine - Adrian Plc | Family Medicine | 818 Riverside Ave, Adrian, MI 49221-1446 | 2016-03-02 |
| 1316325129 | Christina Yancey | Family Medicine | 1200 N Main St, Adrian, MI 49221 | 2015-05-12 |
| 1598021164 | Charan Kanwal Cheema | Family Medicine | 781 Lakeshire Trl, Adrian, MI 49221-1561 | 2012-04-08 |
| 1578797494 | Bates County Memorial Hospital | Family Medicine | 102 E. Main, Adrian, MO 64720 | 2009-05-06 |
| 1790812907 | Promedica Corporation of Michigan | Family Medicine | 777 Kimole Ln, Suite 230, Adrian, MI 49221-1478 | 2007-02-27 |
| 1477689859 | Promedica Corporation of Michigan | Family Medicine | 901 Kimole Ln, Suite A-4, Adrian, MI 49221-1491 | 2007-02-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.