SHIRAZ P TATA PH.D.
NPI 1336298504
Psychologist in Rockford, IL
About Shiraz P Tata Ph.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHIRAZ P TATA PH.D. (NPI 1336298504) is an individual psychologist in Rockford, Illinois, licensed in Illinois (071-004963) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS and is a graduate of Southern Illinois University School Of Medicine (1993).
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
Shiraz P Tata Ph.d. 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 Reassignment
Medicare enrollment records show Shiraz Tata reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Rockford, IL 61114
- Reassigned Medicare billing, Illinois enrollment
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 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ROCKFORD, IL 61114
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 Shiraz Tata's NPI number?
The NPI number for Shiraz Tata is 1336298504. It was assigned to this individual provider in the NPPES registry on January 9, 2007.
Where is Shiraz Tata located?
Shiraz Tata practices at 6072 Brynwood Dr Ste 107, Rockford, IL 61114. The listed phone number is (815) 519-2949.
What is Shiraz Tata's specialty?
The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.
Is Shiraz Tata enrolled in Medicare?
Yes. Shiraz Tata 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 organization bills Medicare for Shiraz Tata's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shiraz Tata reassigns Medicare benefits to Shiraz Tata Phd LLC (Rockford, IL). 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 Shiraz Tata'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 Shiraz Tata was last updated on June 18, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.