Individual provider Active NPI

Tara Lee Lautenslager, M.D.

  • Gastroenterology Physician
  • Mount Laurel, NJ
National Provider Identifier
1114169174
Registry record updated May 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
25MA09466500 Issued in NJ
Practice address
501 Fellowship Rd
Suite 101
Mount Laurel, NJ 08054-3419
Phone
(856) 642-2133
NPI assigned
Apr 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 25MA09466500 NJ Primary

Addresses

Primary practice location

501 Fellowship Rd
Suite 101
Mount Laurel, NJ 08054-3419

Mailing address

1 Federal St # 200
Camden, NJ 08103-1088
Phone (856) 356-4924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20150720001383 NJ Practitioner - GastroenterologyPractitioner - Internal Medicine 3072826015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Rutgers School of Dental Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CMC Department of Medicine Group PAGroup PAC ID 2163335878, 474 clinicians

Practice addresses (Care Compare)

1 Cooper PLZ
Camden, NJ 08103-1461
Phone (856) 342-4192

2 Cooper PLZ
Camden, NJ 08103-1461
Phone (855) 632-2667

3 Cooper PLZ
Camden, NJ 08103-1438

400 W Route 38
FL 2
Moorestown, NJ 08057-3219
Phone (856) 270-4004

501 Fellowship Rd
Suite 101
Mount Laurel, NJ 08054-3419
Phone (856) 642-2133

Hospital & facility affiliations

  • Cooper University Hospital Hospital, Camden, NJ, CCN 310014

Merit-based Incentive Payment System (MIPS)

Final score
91.83 of 100Reported as group
Quality
88.78
Promoting interoperability
99
Improvement activities
40
Cost
74.17

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy80
Upper gastrointestinal (GI) endoscopy for acid reflux74

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CMC Department of Medicine Group PA CurrentSince Jul 1, 2015 Accepting new patients

Locations

3 Cooper Plz
Rm 403
Camden, NJ 08103
Phone (856) 342-2439

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

3 Cooper Plz
Rm 104
Camden, NJ 08103
Phone (609) 963-6770

1 Cooper Plz
Fl 6
Camden, NJ 08103
Phone (856) 342-2065

1 Federal St
#200
Camden, NJ 08103

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

3 Cooper Plz
Rm 311
Camden, NJ 08103
Phone (856) 342-2034

3 Cooper Plz
Rm 215
Camden, NJ 08103
Phone (856) 342-2439

400 W Route 38
Fl 2
Moorestown, NJ 08057
Phone (856) 270-4002

309 Bridgeboro Rd
Moorestown, NJ 08057
Phone (856) 439-2000

501 Fellowship Rd
Ste 101
Mount Laurel, NJ 08054
Phone (856) 963-3572

501 Fellowship Rd
Ste 102
Mount Laurel, NJ 08054
Phone (856) 380-1768

390 N Broadway
Ste 100
Pennsville, NJ 08070
Phone (609) 678-6411

310 Salem Woodstown Rd
Salem, NJ 08079
Phone (856) 339-6054

1 Plaza Dr
Ste 103
Sewell, NJ 08080
Phone (856) 270-4080

6100 Main St
Voorhees, NJ 08043
Phone (856) 673-4912

100 Bowman Dr
Voorhees, NJ 08043
Phone (856) 247-3000

Interoperability endpoints

  • Direct secure messaging: tlautenslager1149@direct.cooperhealth.edu

Organizations & group practices 2

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 2

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": "1238976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557446400000",
    "number": "1114169174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 FELLOWSHIP RD",
            "address_2": "SUITE 101",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080543419",
            "telephone_number": "856-642-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUTENSLAGER",
        "first_name": "TARA",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-06",
        "last_updated": "2019-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MA09466500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

Verify at the official NPI Registry.