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TARA ANN CANCELLARO MD
NPI 1215969167
Pediatrics - Developmental - Behavioral Pediatrics in Greenville, SC

Active since July 07, 2006PECOS Enrolled
29 N ACADEMY ST, GREENVILLE, SC 29601(864) 331-1300 Get Directions Write a Review

NPPES record last updated: May 23, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 23, 2021, Nov 13, 2015 (2 updates tracked since 2015).

About Tara Ann Cancellaro Md NPPES

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

TARA ANN CANCELLARO MD (NPI 1215969167) is an individual developmental - behavioral pediatrics provider in Greenville, South Carolina, licensed in South Carolina (23347) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1215969167
Entity TypeIndividualFemale
Primary Taxonomy2080P0006X
Provider Legal NameTARA ANN CANCELLAROCredential: MD
Location Address29 N ACADEMY STGreenville, SC 29601-2629
Mailing Address300 E Mcbee Ave Fl 4Greenville, SC 29601-2842 · (864) 522-8617
Phone(864) 331-1300
Sole ProprietorNo
Enumeration DateJuly 7, 2006
Last NPPES UpdateMay 23, 20212 updates tracked since enumeration
NPPES CertifiedMay 23, 2021
✔ NPI 1215969167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Developmental - Behavioral PediatricsAllopathic & Osteopathic Physicians
Taxonomy Code2080P0006X
License✔ Licensed in SC · 23347
Definition
A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development.
29 N ACADEMY ST, Greenville, SC 29601
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Other Identifiers 1

MedicaidT75335SC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tara Ann Cancellaro Md 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.

Medicare Billing Reassignment

Medicare enrollment records show Tara Cancellaro reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Prisma Health University Medical Group
2.2 mi
Family Medicine
2A CLEVELAND CT
Greenville, SC 29607
  • Reassigned Medicare billing, South Carolina enrollment
  • 3,281 clinicians in this Medicare group
NPI 1295763217 (864) 454-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

CAITLYN ESTHER SOLTES P.T.
Physical Therapist (Pediatrics)
29 N ACADEMY ST
GREENVILLE, SC 29601
Greenville County (864) 331-1344
DR. SUZANNE CLAYCOMB BROWN PH.D.
Psychologist (School)
29 N ACADEMY ST
GREENVILLE, SC 29601
Greenville County (864) 331-1400
HOLLY KOCH CCC-SLP
Speech-Language Pathologist
29 N ACADEMY ST
GREENVILLE, SC 29601
Greenville County (864) 331-1350
MRS. MARY CAROLYN GILKINSON MSR, SLP
Speech-Language Pathologist
29 N ACADEMY ST
GREENVILLE, SC 29601
Greenville County (864) 331-1380
CLARITY, INC.
Speech-Language Pathologist
29 N ACADEMY ST
GREENVILLE, SC 29601
Greenville County (864) 331-1400
ANDREA L. MURDOCK S.L.P.
Speech-Language Pathologist
29 N ACADEMY ST
GREENVILLE, SC 29601
Greenville County (864) 331-1350
REBECCA GRACE GRATTON OTR/L
Occupational Therapist
29 N ACADEMY ST
GREENVILLE, SC 29601
Greenville County (864) 331-1353
MRS. KELLY MACINTIRE PRATER OTR/L
Occupational Therapist
29 N ACADEMY ST
GREENVILLE, SC 29601
Greenville County (864) 331-1364

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 Cancellaro's NPI number?

The NPI number for Tara Cancellaro is 1215969167. It was assigned to this individual provider in the NPPES registry on July 7, 2006.

Where is Tara Cancellaro located?

Tara Cancellaro practices at 29 N Academy St, Greenville, SC 29601. The listed phone number is (864) 331-1300.

What is Tara Cancellaro's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Developmental - Behavioral Pediatrics, with taxonomy code 2080P0006X.

Is Tara Cancellaro enrolled in Medicare?

Yes. Tara Cancellaro is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Tara Cancellaro's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tara Cancellaro reassigns Medicare benefits to Prisma Health University Medical Group (Greenville, SC). The 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 Cancellaro's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Tara Cancellaro accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and InStil Health list Tara Cancellaro 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.

When was this NPI record last updated?

The NPPES record for Tara Cancellaro was last updated on May 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.