Individual provider Active NPI

Tina M Tamaddon, MD

  • Emergency Medicine Physician
  • Raleigh, NC
National Provider Identifier
1033171046
Registry record updated Mar 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
200300674 Issued in NC
Practice address
3000 New Bern Ave
Raleigh, NC 27610-1231
Phone
(843) 237-3378
Fax
(843) 237-5073
NPI assigned
Apr 5, 2006
Last updated
Mar 17, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 200300674 NC Primary

Addresses

Primary practice location

3000 New Bern Ave
Raleigh, NC 27610-1231

Mailing address

PO Box 60968
Charlotte, NC 28260-0968
Phone (843) 237-3378

Other identifiers 3

IdentifierTypeStateIssuer
134POOtherNCBCBS
5902010MedicaidNC
P00312345OtherNCRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091021000623 GA Practitioner - Emergency Medicine 9032100482 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
State University of Ny Upstate Medical University, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians

Practice addresses (Care Compare)

1350 Walton Way
Augusta, GA 30901-2612
Phone (706) 774-2165

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.67 of 100Reported as group
Improvement activities
40
Cost
79.56

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200300674NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peach State Emergency Physicians LLC Emergency Medicine CurrentSince May 17, 2024 Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Internal Medicine Specialist, PA Past Accepting new patients
Iredell Memorial Hospital, Incorporated Past Accepting new patients
Piedmont Emergency Medical Associates, PA Emergency Medicine Past Accepting new patients

Locations

1350 Walton Way
Augusta, GA 30901
Phone (706) 722-9011

2260 Wrightsboro Rd
Augusta, GA 30904
Phone (706) 481-7000

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

2460 Washington Rd
Thomson, GA 30824
Phone (706) 595-1411

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237248000000",
    "number": "1033171046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60968",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600968",
            "telephone_number": "843-237-3378",
            "fax_number": "843-237-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101231",
            "telephone_number": "843-237-3378",
            "fax_number": "843-237-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMADDON",
        "first_name": "TINA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2009-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "200300674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "134PO",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902010",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00312345",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.