TARA JOAN ANP AND GNP
NPI 1063979896
Nurse Practitioner - Adult Health in Bronx, NY

Q: What is Tara Joan's NPI number?

The NPI number for Tara Joan is 1063979896. It was assigned to this individual provider in the NPPES registry on February 28, 2019.

Q: What is Tara Joan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: When was this NPI record last updated?

The NPPES record for Tara Joan was last updated on July 15, 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.

Active since February 28, 2019PECOS EnrolledAccepts Medicare Assignment

2015 GRAND CONCOURSE, BRONX, NY 10453(718) 299-7295(718) 299-6797 Get Directions Write a Review

NPPES record last updated: July 15, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 15, 2020, Feb 28, 2019 (2 updates tracked since 2019).

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About Tara Joan Anp And Gnp NPPES

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

TARA JOAN ANP AND GNP (NPI 1063979896) is an individual adult health provider in Bronx, New York, licensed in New York (F302878) and active in the NPI registry since February 2019. She is enrolled in Medicare PECOS and is a graduate of Other (1999).

NPPES Registry Identity

NPI1063979896

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameTARA JOANCredential: ANP AND GNP

Location Address2015 GRAND CONCOURSEBronx, NY 10453-4303

Mailing Address1434 Williamsbridge Rd Fl 2Bronx, NY 10461-2507 · (718) 618-0401 · Fax (347) 479-1303

Phone(718) 299-7295

Fax(718) 299-6797

Sole ProprietorNo

Medical School CMSOtherGraduated 1999

Enumeration DateFebruary 28, 2019

Last NPPES UpdateJuly 15, 20202 updates tracked since enumeration

NPPES CertifiedJuly 15, 2020

✔ NPI 1063979896 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in NY · F302878

Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License F340417 (NY)

2015 GRAND CONCOURSE, Bronx, NY 10453

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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

Tara Joan Anp And Gnp 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 ID5193141042

PECOS Enrollment IDI20200821002388

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10453 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

$105.06 typical visit price

range $67.40 – $203.53

Typical copayment $26.26 (range $16.85 – $50.88)

Most-billed visit code 99203

Established Patient

$117.62 typical visit price

range $21.66 – $164.45

Typical copayment $29.40 (range $5.41 – $41.11)

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.

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.

MANA RAO M.D.

Internal Medicine (Infectious Disease)