TARA MAE PETERSON PA-C
NPI 1104474634
Obstetrics & Gynecology - Complex Family Planning in Baldwin Park, CA

Q: What is Tara Peterson's NPI number?

The NPI number for Tara Peterson is 1104474634. It was assigned to this individual provider in the NPPES registry on August 28, 2019.

Q: What is Tara Peterson's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Complex Family Planning, with taxonomy code 207VC0300X.

Q: When was this NPI record last updated?

The NPPES record for Tara Peterson was last updated on June 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 August 28, 2019PECOS Enrolled

4070 STERLING WAY, BALDWIN PARK, CA 91706(626) 798-0706 Get Directions Write a Review

NPPES record last updated: June 23, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 23, 2023, Aug 28, 2019 (2 updates tracked since 2019).

On this page

About Tara Mae Peterson Pa-c NPPES

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

TARA MAE PETERSON PA-C (NPI 1104474634) is an individual complex family planning provider in Baldwin Park, California, licensed in California (61012) and active in the NPI registry since August 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104474634

Entity TypeIndividualFemale

Primary Taxonomy207VC0300X

Provider Legal NameTARA MAE PETERSONCredential: PA-C

Location Address4070 STERLING WAYBaldwin Park, CA 91706-4223

Mailing Address4070 Sterling WayBaldwin Park, CA 91706-4223 · (626) 798-0706

Phone(626) 798-0706

Sole ProprietorNo

Enumeration DateAugust 28, 2019

Last NPPES UpdateJune 23, 20232 updates tracked since enumeration

NPPES CertifiedJune 23, 2023

✔ NPI 1104474634 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · Complex Family PlanningAllopathic & Osteopathic Physicians

Taxonomy Code207VC0300X

License✔ Licensed in CA · 61012

Definition

A complex family planning physician specializes in the diagnosis and treatment of individuals with complex reproductive needs. These physicians are experts in abortion and contraception clinical care, research, education, and advocacy.

4070 STERLING WAY, Baldwin Park, CA 91706

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tara Mae Peterson Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 91706 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

$142.39 typical visit price

range $62.96 – $187.60

Typical copayment $35.59 (range $15.74 – $46.90)

Most-billed visit code 99204

Established Patient

$77.96 typical visit price

range $20.84 – $153.61

Typical copayment $19.49 (range $5.21 – $38.40)

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.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

REZA RADMAND D.M.D INC.

Dentist