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KHRYSTYNA FOMINA MD
NPI 1508614439
Student in an Organized Health Care Education/Training Program in Tucson, AZ

Active since May 07, 2024PECOS Enrolled
2945 W INA RD STE 221, TUCSON, AZ 85741(520) 682-4111(520) 616-1536 Get Directions Write a Review

NPPES record last updated: October 13, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 11, 2025, Jul 3, 2024, May 7, 2024 (3 updates tracked since 2024).

About Khrystyna Fomina Md NPPES

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

KHRYSTYNA FOMINA MD (NPI 1508614439) is an individual student in an organized health care education/training program in Tucson, Arizona, licensed in Arizona (R81187) and active in the NPI registry since May 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1508614439
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameKHRYSTYNA FOMINACredential: MD
Location Address2945 W INA RD STE 221Tucson, AZ 85741-2385
Mailing Address2945 W Ina Rd Ste 221Tucson, AZ 85741-2385 · (520) 682-4111 · Fax (520) 616-1536
Phone(520) 682-4111
Fax(520) 616-1536
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateMay 7, 2024
Last NPPES UpdateOctober 13, 20253 updates tracked since enumeration
NPPES CertifiedOctober 13, 2025
✔ NPI 1508614439 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in AZ · R81187
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2945 W INA RD STE 221, Tucson, AZ 85741
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Khrystyna Fomina Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7618473000
PECOS Enrollment IDI20251003002539
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.

Medicare Billing Reassignment

Medicare enrollment records show Khrystyna Fomina reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Marana Health Center Inc
Same address
Federally Qualified Health Center (FQHC)
2945 W INA RD STE 221&215
Tucson, AZ 85741
  • Reassigned Medicare billing, Arizona enrollment
  • 169 clinicians in this Medicare group
NPI 1669245007 (520) 616-1531

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

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

ADAORA EZEANI MD, MPH
Student in an Organized Health Care Education/Training Program
2945 W INA RD STE 221
TUCSON, AZ 85741
Pima County (520) 616-1531

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Khrystyna Fomina's NPI number?

The NPI number for Khrystyna Fomina is 1508614439. It was assigned to this individual provider in the NPPES registry on May 7, 2024.

Where is Khrystyna Fomina located?

Khrystyna Fomina practices at 2945 W Ina Rd Ste 221, Tucson, AZ 85741. The listed phone number is (520) 682-4111.

What is Khrystyna Fomina's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Khrystyna Fomina enrolled in Medicare?

Yes. Khrystyna Fomina is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Khrystyna Fomina's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Khrystyna Fomina reassigns Medicare benefits to Marana Health Center Inc (Tucson, AZ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Khrystyna Fomina's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Khrystyna Fomina was last updated on October 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.