Individual provider Active NPI

Tara Burlingame, NP

  • Gerontology Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1154190320
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SP028940 Issued in PA
Practice address
5501 Old York Rd
Philadelphia, PA 19141-3018
Phone
(215) 456-3880
NPI assigned
Dec 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X SP028940 PA Primary

Addresses

Primary practice location

5501 Old York Rd
Philadelphia, PA 19141-3018

Mailing address

865 Log College Dr
Warminster, PA 18974-1803
Phone (215) 205-4569

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240311000985 PA Practitioner - Nurse Practitioner 3779929955 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

5501 Old York Rd
Phila, PA 19141-3018
Phone (215) 456-3880

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan, Inc CurrentSince Dec 30, 2023 Accepting new patients
Einstein Practice Plan Inc CurrentSince Dec 30, 2023 Accepting new patients
Einstein Practice Plan Inc Current Accepting new patients

Locations

5501 Old York Rd
Bldg 2ND
Philadelphia, PA 19141
Phone (215) 456-3880

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630

9880 Bustleton Ave
Ste 208
Philadelphia, PA 19115
Phone (215) 667-0667

Organizations & group practices 4

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 1

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": "1703721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1154190320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 LOG COLLEGE DR",
            "city": "WARMINSTER",
            "state": "PA",
            "postal_code": "189741803",
            "telephone_number": "215-205-4569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURLINGAME",
        "first_name": "TARA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-28",
        "last_updated": "2023-12-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP028940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.