NPIMap

Individual provider Active NPI

Tara M Ferguson, DOCTORATE OF PHYSICA

  • Physical Therapist
  • Elizabeth, PA
National Provider Identifier
1215276548
Registry record updated Mar 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT022583 Issued in PA
Practice address
605 Scenery Drive
Elizabeth, PA 15037-2000
Phone
(412) 751-0040
Fax
(412) 751-0041
NPI assigned
Feb 6, 2013
Last updated
Mar 4, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT022583 PA Primary

Addresses

Primary practice location

605 Scenery Drive
Elizabeth, PA 15037-2000

Mailing address

625 Lincoln Ave
Suite 209
North Charleroi, PA 15022-2451
Phone (724) 483-3610

Other identifiers 1

IdentifierTypeStateIssuer
1027971610001MedicaidPA

Other names 1

  • Tara Minkus Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic and Sports Physical Therapy Assoc Inc Past Accepting new patients
Orthopedic and Sports Physical Therapy Associates Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1360108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457049600000",
    "number": "1215276548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 LINCOLN AVE",
            "address_2": "SUITE 209",
            "city": "NORTH CHARLEROI",
            "state": "PA",
            "postal_code": "150222451",
            "telephone_number": "724-483-3610",
            "fax_number": "724-489-4758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 SCENERY DRIVE",
            "city": "ELIZABETH",
            "state": "PA",
            "postal_code": "150372000",
            "telephone_number": "412-751-0040",
            "fax_number": "412-751-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "TARA",
        "middle_name": "M",
        "credential": "DOCTORATE OF PHYSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-06",
        "last_updated": "2016-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT022583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027971610001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "MINKUS",
            "credential": "DOCTORATE OF PHYSICA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elizabeth, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.