Active NPI
Tarrah O'Donnell, PA-C
- Physician Assistant
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9110094
- Practice address
- 737 N Michigan Ave Ste 2270
Chicago, IL 60611-2680 - Phone
- (844) 432-1900
- NPI assigned
- Jan 5, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9110094 | FL | Primary |
Addresses
Primary practice location
737 N Michigan Ave Ste 2270
Chicago, IL 60611-2680
Mailing address
120 Sweetbriar BR
Longwood, FL 32750-2715
Phone (407) 923-5052
Other practice location 1
120 Sweetbriar Br
Longwood, FL 32750-2715
Phone (407) 923-5052
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170619002726 | FL | Practitioner - Physician Assistant | 2365710191 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9110094 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ovation Hand Institute-Illinois, LTD | Current | Accepting new patients | |
| Ovation Hand Institute, LLC | Current | Accepting new patients | |
| Ovation Hand Institute-Wisconsin, SC. | Current | Accepting new patients | |
| Florida Medical Associates LLC | Past | Accepting new patients | |
| Ovation Hand Institute - FL P.a. | Past | Accepting new patients |
Locations
737 N Michigan Ave
Ste 2270
Chicago, IL 60611
Phone (844) 432-1600
2593 Development Dr
Ste 270
Green Bay, WI 54311
10532 N Port Washington Rd
Ste 1A
Mequon, WI 53092
Phone (262) 240-9744
Interoperability endpoints
- tarrah.o.donnell.1@18732.direct.athenahealth.com
Organizations & group practices 5
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.
-
- Orthopaedic Surgery Physician
- Chicago, IL
- NPI 1750849428
-
- Orthopaedic Hand Surgery Physician
- Mequon, WI
- NPI 1144797614
-
- Orthopaedic Hand Surgery Physician
- Fort Myers, FL
- NPI 1932915360
-
- Physical Medicine & Rehabilitation Physician
- Chicago, IL
- NPI 1194320267
-
- Primary Care Clinic/Center
- Lady Lake, FL
- NPI 1336153709
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1483574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589241600000",
"number": "1114462728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 SWEETBRIAR BR",
"city": "LONGWOOD",
"state": "FL",
"postal_code": "327502715",
"telephone_number": "407-923-5052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "737 N MICHIGAN AVE STE 2270",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112680",
"telephone_number": "844-432-1900"
}
],
"practiceLocations": [
{
"address_1": "120 Sweetbriar Br",
"address_purpose": "LOCATION",
"city": "Longwood",
"state": "FL",
"postal_code": "327502715",
"country_code": "US",
"telephone_number": "407-923-5052",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "O'DONNELL",
"first_name": "TARRAH",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-05",
"last_updated": "2020-05-12",
"certification_date": "2020-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "9110094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2020; 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.