STEFANIYA TABANLIEVA N.P.
NPI 1508617630
Nurse Practitioner - Gerontology in San Diego, CA
About Stefaniya Tabanlieva N.p. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
STEFANIYA TABANLIEVA N.P. (NPI 1508617630) is an individual gerontology provider in San Diego, California, licensed in California (95027914) and active in the NPI registry since March 2024. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses 3
Secondary Practice Locations 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Stefaniya Tabanlieva N.p. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
SAN DIEGO, CA 92103
SAN DIEGO, CA 92103
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 Stefaniya Tabanlieva's NPI number?
The NPI number for Stefaniya Tabanlieva is 1508617630. It was assigned to this individual provider in the NPPES registry on March 28, 2024.
Where is Stefaniya Tabanlieva located?
Stefaniya Tabanlieva practices at 200 W Arbor Dr, San Diego, CA 92103. The listed phone number is (800) 926-8273.
What is Stefaniya Tabanlieva's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.
Is Stefaniya Tabanlieva enrolled in Medicare?
Yes. Stefaniya Tabanlieva is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
When was this NPI record last updated?
The NPPES record for Stefaniya Tabanlieva was last updated on December 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Stefaniya Tabanlieva, N.P. · NPI 1508617630
Gerontology physician in San Diego, California. Individual provider, active in the CMS NPPES registry since March 28, 2024.
## Identity
- **NPI:** 1508617630 (Entity type: Individual)
- **Enumerated:** March 28, 2024
- **Primary specialty:** Nurse Practitioner - Gerontology · taxonomy 363LG0600X
- **State license:** 95027914 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 200 W ARBOR DR, San Diego, CA 92103-9000
- **Phone:** (800) 926-8273 · **Fax:** (888) 539-8781
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** December 8, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1508617630) · Data from the CMS NPPES public registry.