TANYA TIVORSAK MD PC (NPI# 1447507645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447507645 |
| Entity Type | Organization |
| Organization Name | TANYA TIVORSAK MD PC |
| Practice Address |
2425 Canyon Blvd Ste 150 Boulder CO 80302-6736 |
| Practice Telephone | 3034401000 |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2013-01-09 |
| Authorized Official Name | TANYA L TIVORSAK (OWNER) |
| Authorized Official Telephone | 3034401000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
50978 | CO | Allopathic & Osteopathic Physicians |
| Street Address |
2425 CANYON BLVD STE 150 |
| City | BOULDER |
| State | CO |
| Zip Code | 80302-6736 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323347 | Aviva Naomi Bannerman | Counselor | 2299pearlst., Boulder, CO 80302 | 2020-07-22 |
| 1205480845 | Mark L Sipowicz | Counselor | 100 Arapahoe Avenue, Boulder, CO 80302 | 2019-08-01 |
| 1366909806 | Brett Adamek | Counselor | 2027 Broadway, Suite E, Boulder, CO 80302 | 2019-02-20 |
| 1124592225 | Stepheny Antrobus | Counselor | 100 Arapahoe Lane, Suite 12, Boulder, CO 80302 | 2019-01-11 |
| 1942721337 | Sasha Marvel Hope | Nutritionist | 2260 Baseline Road #102, Boulder, CO 80302 | 2017-07-06 |
| 1073045365 | Mark Shusterman | Internal Medicine | 2133 5th Street, Boulder, CO 80302 | 2017-03-28 |
| 1316489396 | Agnieszka Spuzak | Nutritionist | 1267 Fourmile Canyon Dr, Boulder, CO 80302 | 2016-11-08 |
| 1265980031 | Tanya Robertson | Physical Therapy Assistant | 1633 Grove Street, Boulder, CO 80302 | 2016-09-21 |
| 1699142380 | Libbey Occupational Therapy Services LLC | Occupational Therapist | 100 West Arapahoe Ln, Suite 12, Boulder, CO 80302 | 2015-08-28 |
| 1831597244 | Annemarie Curran Prairie | Counselor | 2505 Walnut St., Ste 303, Boulder, CO 80302 | 2014-12-17 |
| Find all providers in zip 80302 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992114714 | Clinical Radiologists, S.c. | Radiology | 295 Fox Dr, Boulder, CO 80303-3529 | 2014-08-06 |
| 1073883153 | Cher, LLC | Radiology | 2425 Canyon Blvd, #150, Boulder, CO 80302-6743 | 2012-01-06 |
| 1487803383 | Boulder Community Health | Radiology | 6685 Gunpark Drive East, Suite 110, Boulder, CO 80301-0000 | 2008-09-16 |
| 1053496687 | Francis Ignatius Donahue | Radiology | 770 12th St, Boulder, CO 80302-7519 | 2006-10-25 |
| 1225137102 | Dai Thi Hoang | Radiology | 4919 10th St, Boulder, CO 80304-4354 | 2006-09-21 |
| 1942293485 | Jie Mao | Radiology | 1100 Balsam Ave, Radiology, Boulder, CO 80304-3404 | 2005-08-30 |
| 1295054047 | Natalia Gaulke | Radiology | 1333 Iris Ave, Boulder, CO 80304-2226 | 2010-05-19 |
| 1396867222 | Nicholas Wendell Wickersham | Radiology | 1100 Balsam Ave, Boulder, CO 80304-3404 | 2007-04-03 |
| 1891756813 | Boulder Radiologists Inc P C | Radiology | 4747 Arapahoe Ave, Boulder, CO 80303-1131 | 2006-03-29 |
| 1821063371 | Stephen M Miller | Radiology | 1100 Balsam Ave, Boulder, CO 80304-3404 | 2006-02-20 |
| Find all providers in BOULDER | ||||
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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.