Tatyana N Formuzal, PT is a medicare enrolled "Physical Therapist" physician in Carmichael, California. Her current practice location is
5810 Jameson Ct Ste 1, Carmichael, California. You can reach out to her office (for appointments etc.) via phone at
(916) 979-0621.
Tatyana N Formuzal is licensed to practice in California (license number PT291118) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1821459553.
Physician's Profile
Full Name | Tatyana N Formuzal |
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Gender | Female |
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Speciality | Physical Therapist |
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Location | 5810 Jameson Ct Ste 1, Carmichael, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1821459553
- Provider Enumeration Date: 03/08/2016
- Last Update Date: 07/03/2022
Medicare PECOS Information:
- PECOS PAC ID: 4587031877
- Enrollment ID: I20221028001840
Medical Identifiers
Medical identifiers for Tatyana N Formuzal such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1821459553 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208100000X | Physical Medicine & Rehabilitation | PT291118 (California) | Secondary |
225100000X | Physical Therapist | PT291118 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Tatyana N Formuzal allows following entities to bill medicare on her behalf.
Entity Name | Permanente Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tatyana N Formuzal is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Tatyana N Formuzal, PT 12260 Vineyard Hill Ct, Elk Grove, CA 95624-9531 Ph: () - | Tatyana N Formuzal, PT 5810 Jameson Ct Ste 1, Carmichael, CA 95608-0881 Ph: (916) 979-0621 |
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