TARA SHANNON CONDREY PA
NPI 1083871693
Physician Assistant in Jacksonville, FL

Active since May 21, 2008PECOS EnrolledAccepts Medicare Assignment
58.69/100
CMS Quality Rating
11512 LAKE MEAD AVE, SUITE 531, JACKSONVILLE, FL 32256(904) 419-2054 Get Directions Write a Review

NPPES record last updated: January 6, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Tara Shannon Condrey Pa NPPES

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

TARA SHANNON CONDREY PA (NPI 1083871693) is an individual physician assistant in Jacksonville, Florida, licensed in Florida (PA9104580) and active in the NPI registry since May 2008. She is enrolled in Medicare PECOS, is affiliated with Baptist Health Medical Center - Jacksonville, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1083871693
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameTARA SHANNON CONDREYCredential: PA
Location Address11512 LAKE MEAD AVE, SUITE 531Jacksonville, FL 32256-9680
Mailing Address15280 Nw 79th Ct Ste 200Miami Lakes, FL 33016-5873 · (305) 558-3724 · Fax (786) 907-4485
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateMay 21, 2008
Last NPPES UpdateJanuary 6, 2025
NPPES CertifiedJanuary 6, 2025
NPI 1083871693 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in FL · PA9104580
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

11512 LAKE MEAD AVE, Jacksonville, FL 32256

Other Names 1

Other Name (5)Tara Wall Pa

Other Identifiers 1

Medicaid2930951-00FL

Accepted Insurance

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 Shannon Condrey Pa 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 ID8123190824
PECOS Enrollment IDI20080711000161
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.

Areas of Expertise CMS Part B claims 4

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 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.
54 services50 patients
Diagnostic exam of nasal passages using an endoscope 31231
A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
33 services31 patients
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.
31 services30 patients
Removal of impacted ear wax 69210
Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
24 services21 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Baptist Health Medical Center - Jacksonville

Acute Care Hospitals · Jacksonville, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100088
Location800 Prudential DrJacksonville, FL 32207 · Duval County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32256 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

58.69/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality67.18
Promoting Interoperability0
Improvement Activities40
Cost78.44

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.

Nurse Practitioner (Adult Health)
11512 LAKE MEAD AVE, 513
JACKSONVILLE, FL 32256
Family Medicine
11512 LAKE MEAD AVE, SUITE 521
JACKSONVILLE, FL 32256
Speech-Language Pathologist
11512 LAKE MEAD AVE, SUITE 203
JACKSONVILLE, FL 32256
Speech-Language Pathologist
11512 LAKE MEAD AVE, SUITE 203
JACKSONVILLE, FL 32256
Acupuncturist
11512 LAKE MEAD AVE, SUITE 605
JACKSONVILLE, FL 32256
Plastic Surgery
11512 LAKE MEAD AVE, SUITE 605
JACKSONVILLE, FL 32256
Speech-Language Pathologist
11512 LAKE MEAD AVE, SUITE 203
JACKSONVILLE, FL 32256
Acupuncturist
11512 LAKE MEAD AVE, # 605
JACKSONVILLE, FL 32256

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 Condrey's NPI number?

The NPI number for Tara Condrey is 1083871693. It was assigned to this individual provider in the NPPES registry on May 21, 2008. The provider is also known as Tara Wall PA.

Where is Tara Condrey located?

Tara Condrey practices at 11512 Lake Mead Ave Suite 531, Jacksonville, FL 32256. The listed phone number is (904) 419-2054.

What is Tara Condrey's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Tara Condrey enrolled in Medicare?

Yes. Tara Condrey 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.

What insurance does Tara Condrey accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, AvMed and Oscar Health Maintenance Organization of Florida list Tara Condrey as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Tara Condrey affiliated with any hospitals?

According to CMS data, Tara Condrey is affiliated with Baptist Health Medical Center - Jacksonville.

When was this NPI record last updated?

The NPPES record for Tara Condrey was last updated on January 6, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.