Tara Mae Peterson, PA-C

Primary specialty

Complex Family Planning PhysicianTaxonomy code 207VC0300X

License

61012 Issued in CA

Practice address

4070 Sterling Way
Baldwin Park, CA 91706-4223

Phone

(626) 798-0706

NPI assigned

Aug 28, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tara.petersonpa.p1@direct.plannedparenthoodla.nextgenshare.com

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.

• Planned Parenthood Pasadena and San Gabriel Valley Inc

  • Community Health Clinic/Center
  • Pasadena, CA
  • NPI 1073669040
  NPD
• Planned Parenthood Pasadena and San Gabriel Valley Inc

  • Community Health Clinic/Center
  • Highland Park, CA
  • NPI 1407406630
  NPD
• Planned Parenthood of Greater New York Inc

  • Ambulatory Family Planning Facility
  • Brooklyn, NY
  • NPI 1417959701
  NPD (past)

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1104474634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4070 STERLING WAY",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917064223",
            "telephone_number": "626-798-0706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4070 STERLING WAY",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917064223",
            "telephone_number": "626-798-0706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "TARA",
        "middle_name": "MAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VC0300X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Complex Family Planning",
            "state": "CA",
            "license": "61012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edwin Jude Peres Da Silva, MD
• Melissa Perez, MS
• Saira Perez, DA
• Annette Marie Perry, P.T.
• Natalie Peterson
• Brandon Tyler Pham, MD
• Jessica Van Pham
• Joseph Pham, MD
• Nhu Dinh Pham
• Son-Hung Pham

• Obstetrics & Gynecology Physician in Baldwin Park, CA
• Providers in Baldwin Park, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; 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.

Verify at the official NPI Registry.