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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. TATYANA BORODULIN M.D.
NPI 1912940628
Family Medicine in Campbell, CA

Active since June 13, 2006PECOS EnrolledCLIA 05D2029739 · Waiver
1600 W CAMPBELL AVE, CAMPBELL, CA 95008(408) 378-3300(408) 378-6822 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Tatyana Borodulin M.d. NPPES

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

DR. TATYANA BORODULIN M.D. (NPI 1912940628) is an individual family medicine provider in Campbell, California and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through September 13, 2027, and is a graduate of Other (1988).

NPPES Registry Identity

NPI1912940628
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. TATYANA BORODULINCredential: M.D.
Location Address1600 W CAMPBELL AVECampbell, CA 95008-1526
Mailing Address1600 W Campbell AveCampbell, CA 95008-1526 · (408) 378-3300 · Fax (408) 378-6822
Phone(408) 378-3300
Fax(408) 378-6822
Sole ProprietorNo
Medical School CMSOtherGraduated 1988
Enumeration DateJune 13, 2006
Last NPPES UpdateJuly 13, 2026
✔ NPI 1912940628 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1600 W CAMPBELL AVE, Campbell, CA 95008
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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 and accepts Medicare assignment

Dr. Tatyana Borodulin M.d. 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 ID9537252705
PECOS Enrollment IDI20070904000351
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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2029739

Tatyana V. Borodulin, MD, Inc. · Campbell, CA
Active · expires Sep 13, 2027
CLIA Number05D2029739
Laboratory TypePhysician Office
Certificate Effective DateSeptember 14, 2025
Certificate Expiration DateSeptember 13, 2027
Laboratory DirectorTatyana V. Borodulin
Laboratory Phone(408) 378-3300
Laboratory LocationTatyana V. Borodulin, MD, Inc.1600 W. Campbell Avenue, Suite 202, Campbell, CA 95008
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
145 services46 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
109 services49 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
60 services44 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
38 services38 patients
Telephone medical discussion with physician, 21-30 minutes 99443
This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.
28 services18 patients
Test to measure expiratory airflow and volume 94010
This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.
21 services19 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95008 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
$106.47 typical visit price
range $70.37 – $206.04
Typical copayment $26.61 (range $17.59 – $51.51)
Most-billed visit code 99203
Established Patient
$121.77 typical visit price
range $23.96 – $169.60
Typical copayment $30.44 (range $5.99 – $42.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
9 suppliers27 claims53 services$5.51 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
6 suppliers16 claims16 services$0.99 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 10

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

ZAVACKI CHIROPRACTIC, INC
Chiropractor
1600 W CAMPBELL AVE, SUITE 203
CAMPBELL, CA 95008
Santa Clara County (408) 370-2181
NELSON ALEXANDER DIAZ-CALDERON
Case Manager/Care Coordinator
1600 W CAMPBELL AVE
CAMPBELL, CA 95008
Santa Clara County (408) 846-2100
RODERICK REYES
Case Manager/Care Coordinator
1600 W CAMPBELL AVE, SUIT 102
CAMPBELL, CA 95008
Santa Clara County (408) 871-4965
DR. MICHELLE GRADY PSYD
Psychologist
1600 W CAMPBELL AVE, SUITE 201
CAMPBELL, CA 95008
Santa Clara County (408) 871-4935
BLANCA YVETTE VILLA ASW
Social Worker (Clinical)
1600 W CAMPBELL AVE, SUITE 102
CAMPBELL, CA 95008
Santa Clara County (408) 871-4917
MR. PAUL ARTHUR CABRAL JR. MHRS
Rehabilitation Practitioner
1600 W CAMPBELL AVE, 201
CAMPBELL, CA 95008
Santa Clara County (408) 871-4958
MS. SERENA DAWN MISLEY
Marriage & Family Therapist
1600 W CAMPBELL AVE, SUITE 201
CAMPBELL, CA 95008
Santa Clara County (408) 871-4925
TATYANA V. BORODULIN MD, INC
Family Medicine
1600 W CAMPBELL AVE, SUITE 202
CAMPBELL, CA 95008
Santa Clara County (408) 375-3300

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 Tatyana Borodulin's NPI number?

The NPI number for Tatyana Borodulin is 1912940628. It was assigned to this individual provider in the NPPES registry on June 13, 2006.

Where is Tatyana Borodulin located?

Tatyana Borodulin practices at 1600 W Campbell Ave, Campbell, CA 95008. The listed phone number is (408) 378-3300.

What is Tatyana Borodulin's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Tatyana Borodulin enrolled in Medicare?

Yes. Tatyana Borodulin 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.

Does Tatyana Borodulin hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2029739) is associated with this NPI, valid through September 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Tatyana Borodulin was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 35 days 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.