TARA LYNN SHAFER FNP
NPI 1053922641
Nurse Practitioner - Family in San Pedro, CA
About Tara Lynn Shafer Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TARA LYNN SHAFER FNP (NPI 1053922641) is an individual family provider in San Pedro, California, licensed in California (95015152) and active in the NPI registry since August 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Tara Lynn Shafer Fnp 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.
Medicare Billing Reassignments
2Medicare enrollment records show Tara Shafer reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
San Pedro, CA 90732
- Reassigned Medicare billing, California enrollment
Mission Viejo, CA 92691
- Reassigned Medicare billing, California enrollment
- 15 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 5
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 90732 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Tara Shafer's NPI number?
The NPI number for Tara Shafer is 1053922641. It was assigned to this individual provider in the NPPES registry on August 16, 2020.
Where is Tara Shafer located?
Tara Shafer practices at 1350 W 6th St Ste 200, San Pedro, CA 90732. The listed phone number is (310) 832-0686.
What is Tara Shafer's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Tara Shafer enrolled in Medicare?
Yes. Tara Shafer 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.
Which organizations bill Medicare for Tara Shafer's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tara Shafer reassigns Medicare benefits to 2 organizations: (San Pedro, CA) and Array Skin Therapy, A Medical Corporation (Mission Viejo, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tara Shafer's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Tara Shafer was last updated on August 16, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.
# Tara Lynn Shafer, FNP · NPI 1053922641
Family physician in San Pedro, California. Individual provider, active in the CMS NPPES registry since August 16, 2020.
## Identity
- **NPI:** 1053922641 (Entity type: Individual)
- **Enumerated:** August 16, 2020
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 95015152 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 1350 W 6TH ST STE 200, San Pedro, CA 90732-3508
- **Phone:** (310) 832-0686
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): (NPI 1336243666, San Pedro, CA); Array Skin Therapy, A Medical Corporation (NPI 1891075123, Mission Viejo, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** August 16, 2020
---
Source: [NPI Profile](https://npiprofile.com/npi/1053922641) · Data from the CMS NPPES public registry.