Tara McConnon, DO

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

253285-1 Issued in NY

Practice address

200 Belle Terre Rd
Port Jefferson, NY 11777-1928

Phone

(631) 474-6879

NPI assigned

Aug 27, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physical Medicine and Rehabilitation

Education

New York College of Osteo Medicine of New York Institute of Technology, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Hospital Medical Center Hospital, West Islip, NY, CCN 330286

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles (2 of 6)

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: tmcconnon41030@direct-chsli.net

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.

• CHS Physician Partners, PC

  • Interventional Cardiology Physician
  • Fresh Meadows, NY
  • NPI 1407089345

  NY

  Medicare reassignment Care Compare group NPD
• CHS Physician Partners, P.C

  • Cardiovascular Disease Physician
  • Roslyn, NY
  • NPI 1164585725
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Good Samaritan Hospital Medical Center

  • General Acute Care Hospital
  • West Islip, NY
  • NPI 1902865355

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1235362013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 SWEETBERRY AVE",
            "city": "CENTER MORICHES",
            "state": "NY",
            "postal_code": "119341417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BELLE TERRE RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771928",
            "telephone_number": "631-474-6879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNON",
        "first_name": "TARA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-27",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "253285-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steve Theodore Matthews, DO
• Gabrielle McAndrews, PSY.D.
• Gloria McCann Fortune, NP
• Maureen Veronica McCann, NP
• Maryellen McCarthy
• Darlene McDay, AGNP-C
• Helena McDermott, MSED
• Brian McGinley, MD
• Isadora McGowan
• Regina McGuire, LMFT

• All providers in Port Jefferson, NY
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; 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.
• 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.