Active NPI
Tara Lynn Dupont, M.D.
- Neonatal-Perinatal Medicine Physician
- Albuquerque, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- MD2011-0413
- Practice address
- 2211 Lomas Blvd NE
Albuquerque, NM 87106-2745 - Phone
- (505) 272-5437
- NPI assigned
- May 2, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | M8636 | TX | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | MD2011-0413 | NM | Primary |
Addresses
Primary practice location
2211 Lomas Blvd NE
Albuquerque, NM 87106-2745
Mailing address
933 Bradbury Dr SE
Suite 2222
Albuquerque, NM 87106-4374
Phone (505) 272-3120
Other names 1
- Tara Lynn Sullivan
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tdupont324761@direct.med.utah.edu | Direct | UNIVERSITY OF UTAH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM, UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD2011-0413 | NM | MD | Neonatal-Perinatal Medicine Physician |
| M8636 | TX | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Utah Pediatric Acuity Care | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Unm Medical Group Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| University of Utah Pediatric Acuity Care | Current | Accepting new patients | |
| University of Utah Pediatric Acuity Care | Current | Accepting new patients | |
| Unm Medical Group, Inc. | Current | Accepting new patients | |
| University of Utah Pediatric Acuity Care | Neonatal-Perinatal Medicine | Past | Accepting new patients |
Locations
933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476
2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111
127 S 500 E
Ste 200
Salt Lake City, UT 84102
5121 S Cottonwood St
Ste 100
Salt Lake City, UT 84107
Phone (801) 507-7400
127 S 500 E
Ste 400B
Salt Lake City, UT 84102
Phone (801) 587-6478
400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080
100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
Interoperability endpoints
- tdupont173233@ahs.direct-ci.com
Organizations & group practices 9
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.
-
- Multi-Specialty Clinic/Center
- Albuquerque, NM
- NPI 1831218627
-
- Multi-Specialty Clinic/Center
- Murray, UT
- NPI 1629260880
-
- Pediatric Critical Care Medicine Physician
- Salt Lake City, UT
- NPI 1619325131
-
- Community/Retail Pharmacy
- Albuquerque, NM
- NPI 1417330044
-
- Multi-Specialty Clinic/Center
- Sandy, UT
- NPI 1699909457
-
- Psychiatry Physician
- St George, UT
- NPI 1023843844
-
- Pediatric Critical Care Medicine Physician
- Riverton, UT
- NPI 1376907410
-
- Pediatric Hospice and Palliative Medicine Physician
- Salt Lake City, UT
- NPI 1851898365
-
- Neonatal-Perinatal Medicine Physician
- Salt Lake City, UT
- NPI 1770947814
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634774400000",
"number": "1104047265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "933 BRADBURY DR SE",
"address_2": "SUITE 2222",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871064374",
"telephone_number": "505-272-3120",
"fax_number": "505-272-8060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2211 LOMAS BLVD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871062745",
"telephone_number": "505-272-5437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUPONT",
"first_name": "TARA",
"middle_name": "LYNN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-02",
"last_updated": "2021-10-21",
"certification_date": "2021-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "TX",
"license": "M8636",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "NM",
"license": "MD2011-0413",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tdupont324761@direct.med.utah.edu",
"affiliation": "Y",
"affiliationName": "UNIVERSITY OF UTAH",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "50 N Medical Dr",
"city": "Salt Lake City",
"state": "UT",
"country_code": "US",
"postal_code": "841320001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "TARA",
"last_name": "SULLIVAN",
"middle_name": "LYNN",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.