Stacy Tamara Tarradath, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

AAA4688 Issued in CA

Practice address

8501 Wilshire Blvd Ste 150
Beverly Hills, CA 90211-3148

Phone

(310) 248-7000

Fax

(310) 248-7033

NPI assigned

Sep 3, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Family Practice

Education

State University of Ny Upstate Medical University, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Kedren Community Health Center Inc Kedren Child Development Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1417378597

  Corporate Director

  CMS ownership

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.

• Exer Medical Corporation

  • Urgent Care Clinic/Center
  • Calabasas, CA
  • NPI 1588901532
  Medicare reassignment Care Compare group NPD
• Healthcare Partners Affiliates Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593

  Family Medicine

  Medicare reassignment NPD
• Healthcare Partners Affiliates Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD
• Healthcare Partners Affiliates Medical Group

  • Addiction Medicine (Internal Medicine) Physician
  • Tustin, CA
  • NPI 1891981502
  NPD

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1053569095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3175 23RD ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111064134",
            "telephone_number": "718-956-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8501 WILSHIRE BLVD STE 150",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902113148",
            "telephone_number": "310-248-7000",
            "fax_number": "310-248-7033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3175 23rd St",
            "address_purpose": "LOCATION",
            "city": "Astoria",
            "state": "NY",
            "postal_code": "111064134",
            "country_code": "US",
            "telephone_number": "718-956-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TARRADATH",
        "first_name": "STACY",
        "middle_name": "TAMARA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "278459 DUP",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "AAA4688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Nakjiri,DDS.Inc
• Mark E Tarica, DDS
• Samuel Ralph Tarica, D.D.S.
• Tarneja Anesthesiology Inc
• Neel Tarneja, M.D.
• Taryne Imai M D a Professional Corporation
• Tash Mind Institute Inc
• Christine Taline Tashjian, PHARMD
• Peyman Tashkandi, D.O
• Tasker & Rowan Wilshire Dental Corporation

• Family Medicine Physician in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.