Individual provider Active NPI

Tara Fisher, DPT

  • Orthopedic Physical Therapist
  • Melbourne, FL
National Provider Identifier
1154529634
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT28732 Issued in FL
Practice address
3680 N Wickham Rd Ste B
Melbourne, FL 32935-2327
Phone
(321) 255-5500
Fax
(321) 255-5551
NPI assigned
Jul 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2782 HI
Physical Therapist 225100000X 9639 CO
Physical Therapist 225100000X 28732 FL
Orthopedic Physical Therapist 2251X0800X PT28732 FL Primary

Addresses

Primary practice location

3680 N Wickham Rd Ste B
Melbourne, FL 32935-2327

Mailing address

5565 N Wickham Rd
Melbourne, FL 32940-7304
Phone (407) 573-3352

Other identifiers 2

IdentifierTypeStateIssuer
9639OtherCOCO LICENSE
28732OtherFLFL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230217001605 FL Practitioner - Physical Therapist in Private Practice 8729172762 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

5565 N Wickham Rd
Melbourne, FL 32940-7304
Phone (321) 843-5851

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
9639COMDGeneral Practice Dentistry
28732FLMDPhysical Therapist
2782HIMDPhysical Therapist
PT28732FLMDOrthopedic Physical Therapist

Practice roles (9 of 11)

OrganizationSpecialtyStatusNew patients
Beachside Physical Therapy, Inc. Physical Therapist Current Accepting new patients
Beachside Physical Therapy, Inc Physical Therapist CurrentSince Feb 1, 2023 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Sep 1, 2024 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Sep 1, 2024 Accepting new patients
Tara Fisher DPT LLC Physical Therapist Current Accepting new patients
Beachside Physical Therapy Inc Physical Therapist CurrentSince Feb 1, 2023 Accepting new patients
Kauai Independent Rehabilitation Associates, LLC Physical Therapist Past Accepting new patients
Cora Health Services Inc Past Accepting new patients
Cora Health Services, Inc Past Accepting new patients

Locations

660 E Eau Gallie Blvd
Ste 106
Indian Harbour Beach, FL 32937
Phone (321) 773-5290

3680 N Wickham Rd
Ste B
Melbourne, FL 32935
Phone (321) 255-5500

5565 N Wickham Rd
Melbourne, FL 32940
Phone (407) 573-3352

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

1900 N Alafaya Trl
Ste 900
Orlando, FL 32826
Phone (407) 380-8705

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1154529634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5565 N WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407304",
            "telephone_number": "407-573-3352",
            "fax_number": "407-573-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 N WICKHAM RD STE B",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352327",
            "telephone_number": "321-255-5500",
            "fax_number": "321-255-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "TARA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-06",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "2782",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "9639",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "28732",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "PT28732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CO LICENSE",
            "identifier": "9639",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL LICENSE",
            "identifier": "28732",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.