NPIMap

Individual provider Active NPI

Tara Ann Longoria, M.D.

  • Family Medicine Physician
  • Scottsbluff, NE
National Provider Identifier
1245246180
Registry record updated Feb 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
470788581 Issued in NE
Practice address
3911 Avenue B
Suite 1100
Scottsbluff, NE 69361-4617
Phone
(308) 630-2100
Fax
(308) 630-2113
NPI assigned
Jul 31, 2006
Last updated
Feb 10, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 470788581 NE Primary

Addresses

Primary practice location

3911 Avenue B
Suite 1100
Scottsbluff, NE 69361-4617

Mailing address

18 Sitzman CT
Scottsbluff, NE 69361-4697
Phone (308) 632-6310

Other identifiers 1

IdentifierTypeStateIssuer
080165023OtherPALMENTO GBA RR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081008000294 NE Practitioner - Family Practice 0143398834 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional West Physicians ClinicGroup PAC ID 2062301609, 136 clinicians

Practice addresses (Care Compare)

1102 W 42ND St
Western Nebraska Veterans Home
Scottsbluff, NE 69361-4711
Phone (402) 471-1831

3911 Ave B
Scottsbluff, NE 69361-4617
Phone (308) 630-2100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.07 of 100Reported as group
Quality
62.54
Promoting interoperability
98
Improvement activities
40
Cost
72.7

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
State of Nebraska Dept of Admin Services CurrentSince Feb 18, 2010 Accepting new patients
Regional West Physicians Clinic Family Medicine CurrentSince Sep 1, 2008 Accepting new patients
State of Nebraska Dept of Admin Services Current Accepting new patients
State of Nebraska Dept of Admin Services CurrentSince Feb 18, 2010 Accepting new patients
VSL Gering LLC Past Accepting new patients
Scottsbluff Operations LLC Past Accepting new patients
Regional West Physicians Clinic Past Accepting new patients

Locations

1275 Sage St
Gering, NE 69341
Phone (308) 436-2101

1102 W 42nd St
Scottsbluff, NE 69361
Phone (308) 632-0324

3911 Avenue B
Ste 1100
Scottsbluff, NE 69361
Phone (308) 630-1355

3911 Avenue B
Ste G200
Scottsbluff, NE 69361
Phone (308) 630-1355

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Heritage EstatesGering, NE, CCN 285071 Skilled nursing facility Contracted Managing Employee
Operational/Managerial Control		 Jul 1, 2017
Jul 1, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • VSL Gering LLC

    dba Heritage Estates

    • Skilled Nursing Facility
    • Gering, NE
    • NPI 1053840298

    Contracted Managing Employee, Operational/Managerial Control

    CMS ownership

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391990400000",
    "number": "1245246180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 SITZMAN CT",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693614697",
            "telephone_number": "308-632-6310",
            "fax_number": "308-630-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 AVENUE B",
            "address_2": "SUITE 1100",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693614617",
            "telephone_number": "308-630-2100",
            "fax_number": "308-630-2113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGORIA",
        "first_name": "TARA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2014-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "470788581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMENTO GBA RR MEDICARE",
            "identifier": "080165023",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsbluff, NE

Sources for this page

Verify at the official NPI Registry.