NPIMap

Individual provider Active NPI

Laura Tavarez, MD

  • Family Medicine Physician
  • Forked River, NJ
National Provider Identifier
1053675397
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA09703900 Issued in NJ
Practice address
138 S Main St
Forked River, NJ 08731-3625
Phone
(609) 756-0000
NPI assigned
Jul 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 25MA09703900 NJ Primary

Addresses

Primary practice location

138 S Main St
Forked River, NJ 08731-3625

Mailing address

138 S Main St
Forked River, NJ 08731-3625
Phone (609) 756-0000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150812007047 NJ Practitioner - Family Practice 8921313586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Howard University College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hackensack Meridian Health Medical Group - Primary Care PCGroup PAC ID 7911003330, 364 clinicians

Practice addresses (Care Compare)

138 Route 9
Forked River, NJ 08731-3625
Phone (732) 244-2700

Hospital & facility affiliations

  • Visiting Nurse Association of Central Jersey Home Care and Hospice Home health agency, Toms River, NJ, CCN 317067
  • Bayada Home Health Care, Inc Home health agency, Whiting, NJ, CCN 317031
  • Southern Ocean Medical Center Hospital, Manahawkin, NJ, CCN 310113
  • Jersey Shore University Medical Center Hospital, Neptune, NJ, CCN 310073
  • Community Medical Center Hospital, Toms River, NJ, CCN 310041
  • Ocean Medical Center Hospital, Brick, NJ, CCN 310052
  • Monmouth Medical Center Hospital, Long Branch, NJ, CCN 310075

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09703900NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Primary Care PC Family Medicine CurrentSince Jan 24, 2017 Accepting new patients

Locations

985 Cedar Bridge Ave
Brick, NJ 08723
Phone (732) 477-5600

138 S Main St
Forked River, NJ 08731
Phone (609) 693-7021

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

225 60th St
West New York, NJ 07093
Phone (201) 869-8888

Interoperability endpoints

  • Direct secure messaging: laura.tavarez@direct.hackensackmeridian.org
  • FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/

Organizations & group practices 1

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 10

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": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1053675397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 S MAIN ST",
            "city": "FORKED RIVER",
            "state": "NJ",
            "postal_code": "087313625",
            "telephone_number": "609-756-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 S MAIN ST",
            "city": "FORKED RIVER",
            "state": "NJ",
            "postal_code": "087313625",
            "telephone_number": "609-756-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVAREZ",
        "first_name": "LAURA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-02",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA09703900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forked River, NJ

Sources for this page

Verify at the official NPI Registry.