TATYANA KOVALEVSKIJ
NPI 1487269346
Physician Assistant in San Rafael, CA

Active since September 08, 2020PECOS Enrolled
50 ACACIA AVE, SAN RAFAEL, CA 94901(415) 457-4440 Get Directions Write a Review

NPPES record last updated: May 7, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 7, 2026, Sep 8, 2020 (2 updates tracked since 2020).

About Tatyana Kovalevskij NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TATYANA KOVALEVSKIJ (NPI 1487269346) is an individual physician assistant in San Rafael, California, licensed in California (PA60763) and active in the NPI registry since September 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1487269346
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameTATYANA KOVALEVSKIJ
Location Address50 ACACIA AVESan Rafael, CA 94901-2230
Mailing Address604 Stoneyford DrDaly City, CA 94015-3709 · (415) 361-1901
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateSeptember 8, 2020
Last NPPES UpdateMay 7, 20262 updates tracked since enumeration
NPPES CertifiedMay 7, 2026
NPI 1487269346 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in CA · PA60763
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

50 ACACIA AVE, San Rafael, CA 94901

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Tatyana Kovalevskij is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9032697040
PECOS Enrollment IDI20260131000398
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94901 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$104.67 typical visit price
range $69.07 – $202.63
Typical copayment $26.16 (range $17.26 – $50.65)
Most-billed visit code 99203
Established Patient
$85.00 typical visit price
range $23.44 – $166.64
Typical copayment $21.25 (range $5.86 – $41.66)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Specialist
50 ACACIA AVE
SAN RAFAEL, CA 94901
Physician Assistant
50 ACACIA AVE
SAN RAFAEL, CA 94901
Physician Assistant
50 ACACIA AVE
SAN RAFAEL, CA 94901
Student in an Organized Health Care Education/Training Program
50 ACACIA AVE
SAN RAFAEL, CA 94901
Student in an Organized Health Care Education/Training Program
50 ACACIA AVE
SAN RAFAEL, CA 94901
Student in an Organized Health Care Education/Training Program
50 ACACIA AVE
SAN RAFAEL, CA 94901
Physician Assistant
50 ACACIA AVE
SAN RAFAEL, CA 94901
Physician Assistant
50 ACACIA AVE
SAN RAFAEL, CA 94901

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1487269346, enumerated as an "individual" on September 08, 2020.

The provider is located at 50 ACACIA AVE SAN RAFAEL, CA 94901 and the phone number is (415) 457-4440.

Physician Assistant with taxonomy code 363A00000X.