Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Tatiana Mudrenko, PA

Individual provider Surgical Physician Assistant · NPI 1417513490

Mrs. Tatiana Mudrenko, PA is a Physician Assistant in Roseville, California. Qualified in 2019, 7 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment.

Years since qualifying
7
In the registry since
2019
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1600 Eureka Rd
Roseville, CA 95661-3027
Phone: (877) 457-4772
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X

Record details

NPI number1417513490
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 15, 2019
Last updated in NPPESJanuary 11, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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