Individual provider Active NPI

Tara R Paige, MD

  • Obstetrics & Gynecology Physician
  • Philadelphia, PA
National Provider Identifier
1053496323
Registry record updated Oct 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD060969 Issued in PA
Practice address
301 South 8TH Street
Suite 3D
Philadelphia, PA 19106-4035
Phone
(215) 829-5300
NPI assigned
Oct 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 25MA06617500 NJ
Obstetrics & Gynecology Physician 207V00000X MD060969 PA Primary

Addresses

Primary practice location

301 South 8TH Street
Suite 3D
Philadelphia, PA 19106-4035

Mailing address

301 South 8TH Street
Suite 3D
Philadelphia, PA 19106
Phone (215) 829-5300

Other identifiers 1

IdentifierTypeStateIssuer
7479409MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20091020000466 PA Practitioner - Obstetrics/Gynecology 1355434994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
New York Medical College, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

800 Walnut St FL
12 OB/GYN Wash SQ 12TH
Philadelphia, PA 19107-5176
Phone (215) 829-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06617500NJMDObstetrics & Gynecology Physician
MD060969PAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Oct 21, 2013 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Oct 21, 2013 Accepting new patients
The Pennsylvania Hospital of the University of Pennsylvania Health Sys Past Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst Obstetrics & Gynecology Past Accepting new patients

Locations

800 Walnut St
Fl 12
Philadelphia, PA 19107

700 Spruce St
Ste 200
Philadelphia, PA 19106
Phone (215) 829-3525

800 Walnut St
Fl 15
Philadelphia, PA 19107

801 Spruce St
Philadelphia, PA 19107
Phone (215) 829-3396

7133 Roosevelt Blvd
Philadelphia, PA 19149
Phone (215) 333-3311

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 4

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

Hospital & facility affiliations 3

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349827200000",
    "number": "1053496323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SOUTH 8TH STREET",
            "address_2": "SUITE 3D",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19106",
            "telephone_number": "215-829-5300",
            "fax_number": "215-829-5012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SOUTH 8TH STREET",
            "address_2": "SUITE 3D",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191064035",
            "telephone_number": "215-829-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAIGE",
        "first_name": "TARA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2012-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA06617500",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD060969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7479409",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.