MATTIE BOEHLER-TATMAN MD
NPI 1710622048
Student in an Organized Health Care Education/Training Program in Santa Monica, CA

Q: What is Mattie Boehler-tatman's NPI number?

The NPI number for Mattie Boehler-tatman is 1710622048. It was assigned to this individual provider in the NPPES registry on May 2, 2022.

Q: What is Mattie Boehler-tatman's specialty?

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

Active since May 02, 2022PECOS Enrolled

1250 16TH ST, SANTA MONICA, CA 90404(310) 825-9111 Get Directions Write a Review

NPPES record last updated: August 6, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Aug 6, 2026, May 2, 2022 (2 updates tracked since 2022).

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About Mattie Boehler-tatman Md NPPES

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

MATTIE BOEHLER-TATMAN MD (NPI 1710622048) is an individual student in an organized health care education/training program in Santa Monica, California and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710622048

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameMATTIE BOEHLER-TATMANCredential: MD

Location Address1250 16TH STSanta Monica, CA 90404-1249

Mailing Address1250 16th StSanta Monica, CA 90404-1249

Phone(310) 825-9111

Sole ProprietorNo

Enumeration DateMay 2, 2022

Last NPPES UpdateAugust 6, 20262 updates tracked since enumeration

NPPES CertifiedAugust 6, 2026

✔ NPI 1710622048 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

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.

1250 16TH ST, Santa Monica, CA 90404

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mattie Boehler-tatman Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

ISABELLA JUSAY NP

Nurse Practitioner