Tara Goldsmith
Individual provider Active NPI Nurse Practitioner · Mangonia Park, FL
NPI 1174290779 · NPPES record last updated Aug 1, 2024
Key facts
- NPI
- 1174290779
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- APRN11019678 (FL)
- Practice address
- 901 45TH St
Mangonia Park, FL 33407-2413 - Phone
- (561) 844-5255
- Fax
- (561) 844-5245
- NPI assigned
- Aug 23, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220615003165 | FL | Practitioner - Nurse Practitioner | 7113306580 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11019678 | FL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tenet Florida Physician Services II, LLC | Current |
Accepting new patients | |
| Tenet Florida Physician Services II, LLC | Nurse Practitioner | Current | Accepting new patients |
| Tenet Florida Physician Services LLC | Current |
Accepting new patients |
Locations
901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300
1000 NE 56th St
Oakland Park, FL 33334
Phone (954) 229-8608
5325 Greenwood Ave
Ste 101
West Palm Beach, FL 33407
Phone (561) 830-6093
Interoperability endpoints
- tara.goldsmith.1@13023.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APRN11019678 | FL | Yes |
Addresses
Primary practice location
901 45TH St
Mangonia Park, FL 33407-2413
Mailing address
PO Box 20802
Belfast, ME 04915-4105
Phone (561) 844-5255
Other providers in Mangonia Park, FL
- Florida Woman Care LLC
- FWC Perinatal, LLC
- FWC Urogynecology, LLC
- General Surgery of Jupiter Medical Specialists, LLC
- Kyle Gerakopoulos
- Elisabeth Gonzalez
- Narayana Gowda
- Grandma Fee-Fee'S Home Care, LLC
- Kari R Greer
- George Gurdock
All providers in Mangonia Park, FL · Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.