Active NPI
Tashara Natashja Gray, MD
- Pediatrics Physician
- Goodyear, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 61785
- Practice address
- 13471 W Cornerstone Blvd
Goodyear, AZ 85395-2713 - Phone
- (480) 964-2273
- NPI assigned
- Jun 6, 2011
- Last updated
- May 17, 2023
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | LL33679 | SC | |
| Pediatrics Physician | 208000000X | ME119054 | FL | |
| Pediatrics Physician | 208000000X | 61785 | AZ | Primary |
Addresses
Primary practice location
13471 W Cornerstone Blvd
Goodyear, AZ 85395-2713
Mailing address
3033 N Central Ave Ste 145
Phoenix, AZ 85012-2808
Phone (623) 583-3001
Other names 1
- Dr. Tashara Natashja Martin
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61785 | AZ | MD | Pediatrics Physician |
| ME119054 | FL | MD | Pediatrics Physician |
| LL33679 | SC | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adelante Healthcare, Inc. | Family Medicine | Current | Accepting new patients |
| Adelante Healthcare, Inc | Current | Accepting new patients | |
| Adelante Healthcare, Inc. | Family Medicine | Current | Accepting new patients |
| Adelante Healthcare, Inc. | Family Medicine | Past | Accepting new patients |
Locations
306 E Monroe Ave
Buckeye, AZ 85326
Phone (623) 386-4814
13471 W Cornerstone Blvd
Goodyear, AZ 85395
Phone (844) 551-6691
1705 W Main St
Mesa, AZ 85201
Phone (480) 845-6769
15525 N 83rd Ave
Ste 104
Peoria, AZ 85382
3033 N Central Ave
Ste 145
Phoenix, AZ 85012
500 W Thomas Rd
Ste 870
Phoenix, AZ 85013
Phone (602) 263-0222
7725 N 43rd Ave
Ste 510
Phoenix, AZ 85051
Phone (623) 207-5465
15317 W Bell Rd
Ste 100
Surprise, AZ 85374
15317 W Bell Rd
Ste 108
Surprise, AZ 85374
Phone (717) 299-6372
15351 W Bell Rd
Surprise, AZ 85374
811 N Tegner St
Ste 113
Wickenburg, AZ 85390
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Adelante Healthcare-Wickenburg
- Federally Qualified Health Center (FQHC)
- Wickenburg, AZ
- NPI 1083772545
Family Medicine
-
dba Adelante Healthcare-Roosevelt
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1215734124
-
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1528126133
Family Medicine
-
dba Adelante Healthcare-Surprise
- Federally Qualified Health Center (FQHC)
- Surprise, AZ
- NPI 1205994761
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684281600000",
"number": "1194019398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3033 N CENTRAL AVE STE 145",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850122808",
"telephone_number": "623-583-3001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13471 W CORNERSTONE BLVD",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853952713",
"telephone_number": "480-964-2273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "TASHARA",
"middle_name": "NATASHJA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-06",
"last_updated": "2023-05-17",
"certification_date": "2023-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "SC",
"license": "LL33679",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME119054",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AZ",
"license": "61785",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TASHARA",
"last_name": "MARTIN",
"middle_name": "NATASHJA",
"prefix": "DR.",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Goodyear, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; 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.