Individual provider Active NPI

Tara Strong Heburn, PA-C

  • Physician Assistant
  • Port Charlotte, FL
National Provider Identifier
1215327853
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9108554 Issued in FL
Practice address
2343 Aaron St
Port Charlotte, FL 33952-5305
Phone
(855) 979-5700
NPI assigned
Feb 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X PA9108554 FL
Medical Physician Assistant 363AM0700X PA9108554 FL
Physician Assistant 363A00000X PA9108554 FL Primary

Addresses

Primary practice location

2343 Aaron St
Port Charlotte, FL 33952-5305

Mailing address

PO Box 11126
Belfast, ME 04915-4002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150320001101 FL Practitioner - Physician Assistant 5395062863 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mori Bean and Brooks IncGroup PAC ID 8820077878, 966 clinicians
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

1700 S Tamiami TRL
Sarasota, FL 34239-3509
Phone (904) 399-5550

19531 Cochran Blvd
Port Charlotte, FL 33948-2081
Phone (941) 255-3535

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 399-5550

2600 Laurel Rd E
Nokomis, FL 34275-3226
Phone (904) 399-5550

4761 Sacra CT
Sarasota, FL 34240-4712
Phone (904) 399-5550

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.41 of 100Reported as group
Quality
86.08
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince Sep 2, 2025 Accepting new patients
Millennium Physician Group LLC CurrentSince Sep 2, 2025 Accepting new patients
ENT and Allergy Associates of Florida, LLC Past Accepting new patients

Locations

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

2343 Aaron St
Pt Charlotte, FL 33952
Phone (855) 979-5700

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: tara.heburn.1@4290.direct.athenahealth.com

Organizations & group practices 7

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 2

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": "1423008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1215327853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11126",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2343 AARON ST",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525305",
            "telephone_number": "855-979-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBURN",
        "first_name": "TARA",
        "middle_name": "STRONG",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-04",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "PA9108554",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9108554",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.