DR. TINA BOORTALARY MD
NPI 1912563834
Student in an Organized Health Care Education/Training Program in Philadelphia, PA

Active since May 16, 2019PECOS EnrolledAccepts Medicare Assignment
833 CHESTNUT ST STE 220, PHILADELPHIA, PA 19107(215) 955-8465 Get Directions Write a Review

NPPES record last updated: May 16, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Tina Boortalary Md NPPES

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

DR. TINA BOORTALARY MD (NPI 1912563834) is an individual student in an organized health care education/training program in Philadelphia, Pennsylvania and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS, is affiliated with Thomas Jefferson University Hospital, and maintains a secondary practice location in Philadelphia.

NPPES Registry Identity

NPI1912563834
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameDR. TINA BOORTALARYCredential: MD
Location Address833 CHESTNUT ST STE 220Philadelphia, PA 19107-4405
Mailing Address833 Chestnut St Ste 220Philadelphia, PA 19107-4405 · (215) 955-8465
Sole ProprietorNo
Medical School CMSGeorge Washington University School Of MedicineGraduated 2019
Enumeration DateMay 16, 2019
NPI 1912563834 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

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.

833 CHESTNUT ST STE 220, Philadelphia, PA 19107

Secondary Practice Location 1

Location 1111 S 11th StPhiladelphia, PA 19107-4824 · Phone (215) 955-6610

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

Dr. Tina Boortalary Md 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.

PECOS PAC ID5597090696
PECOS Enrollment IDI20220621000207
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Thomas Jefferson University Hospital

Acute Care Hospitals · Philadelphia, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390174
Location111 South 11th StreetPhiladelphia, PA 19107 · Philadelphia County
Emergency services Birthing friendly

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.

Student in an Organized Health Care Education/Training Program
833 CHESTNUT ST STE 220
PHILADELPHIA, PA 19107
Student in an Organized Health Care Education/Training Program
833 CHESTNUT ST STE 220
PHILADELPHIA, PA 19107
Student in an Organized Health Care Education/Training Program
833 CHESTNUT ST STE 220
PHILADELPHIA, PA 19107
Internal Medicine
833 CHESTNUT ST STE 220
PHILADELPHIA, PA 19107
Student in an Organized Health Care Education/Training Program
833 CHESTNUT ST STE 220
PHILADELPHIA, PA 19107
Internal Medicine
833 CHESTNUT ST STE 220
PHILADELPHIA, PA 19107
Internal Medicine
833 CHESTNUT ST STE 220
PHILADELPHIA, PA 19107
Student in an Organized Health Care Education/Training Program
833 CHESTNUT ST STE 220
PHILADELPHIA, PA 19107

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 Tina Boortalary's NPI number?

The NPI number for Tina Boortalary is 1912563834. It was assigned to this individual provider in the NPPES registry on May 16, 2019.

Where is Tina Boortalary located?

Tina Boortalary practices at 833 Chestnut St Ste 220, Philadelphia, PA 19107. The listed phone number is (215) 955-8465.

What is Tina Boortalary's specialty?

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

Is Tina Boortalary enrolled in Medicare?

Yes. Tina Boortalary 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.

Is Tina Boortalary affiliated with any hospitals?

According to CMS data, Tina Boortalary is affiliated with Thomas Jefferson University Hospital.

When was this NPI record last updated?

The NPPES record for Tina Boortalary was last updated on May 16, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.