Tara Maria Ostrom, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

26889 Issued in AZ

Practice address

20040 N 19TH Ave
Suite a
Phoenix, AZ 85027-4255

Phone

(623) 869-5000

Fax

(623) 869-0927

NPI assigned

Oct 13, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Internal Medicine

Education

University of Southern California Keck School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Greater Phoenix Collaborative Care PCGroup PAC ID 0941503304, 111 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tostrom113012@westdirect.optum.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.

• Greater Phoenix Collaborative Care PC

  • Clinic/Center
  • Phoenix, AZ
  • NPI 1750686614
  Medicare reassignment Care Compare group NPD
• Centerwell Senior Primary Care Az PC

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1073260352
  Medicare reassignment
• Greater Phoenix Collaborative Care PC

  • Diagnostic Radiology Physician
  • Phoenix, AZ
  • NPI 1790581742
  NPD
• Surprise Health Center, PLLC

  • Family Medicine Physician
  • Surprise, AZ
  • NPI 1467563718

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485475200000",
    "number": "1124017009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "623-869-5000",
            "fax_number": "623-869-0927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20040 N 19TH AVE",
            "address_2": "SUITE A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274255",
            "telephone_number": "623-869-5000",
            "fax_number": "623-869-0927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTROM",
        "first_name": "TARA",
        "middle_name": "MARIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2017-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "26889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "565492",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Ostlund
• Julia Ostoich, DPT
• Kathryn Ostrander, DAT, ATC
• Jennifer Ostreicher
• Ann W Ostrom, PT
• Jennifer Osuna
• Anthony W Osvog, LMSW
• Amber Renae Oswald, PT, DPT
• Sarina Begay Otero
• Sharina J Otero, BHT

• Internal Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.