Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Tiara Roter Boquiren, PA-C

Individual provider Physician Assistant · NPI 1770290579

Tiara Roter Boquiren, PA-C is a Physician Assistant in Austin, Texas. Qualified in 2023, 3 years ago. Practices with St Davids Heart and Vascular PLLC, a 198-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
3
Licensed in
TX
In the registry since
2022
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3801 N Lamar Blvd Ste 300
Austin, TX 78756-4080
Phone: (512) 206-3600
Fax: (512) 407-1874
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA18123 (TX)
Physician Assistant Taxonomy 363A00000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1770290579
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedNovember 1, 2022
Last updated in NPPESJuly 17, 2024
Certification dateJuly 15, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice St Davids Heart And Vascular Pllc — 198 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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