NPIMap

Individual provider Active NPI

Tara Devaraj, MD

  • Family Medicine Physician
  • Camp Hill, PA
National Provider Identifier
1245643956
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD460966 Issued in PA
Practice address
3025 Market St Ste B
Camp Hill, PA 17011-4518
Phone
(717) 691-1212
Fax
(717) 691-5354
NPI assigned
Jun 10, 2014
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MT206104 PA
Family Medicine Physician 207Q00000X MD460966 PA Primary

Addresses

Primary practice location

3025 Market St Ste B
Camp Hill, PA 17011-4518

Mailing address

PO Box 858
MC 410
Hershey, PA 17033-0858
Phone (800) 243-1455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20170719000053 PA Practitioner - Family Practice 0244521524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Jefferson Medical College of Thomas Jefferson University, 2014
Medicare assignment
May accept Medicare assignment
Group practices
PSHR Physical Therapy, LLCGroup PAC ID 8628396546, 36 clinicians

Practice addresses (Care Compare)

3025 Market St
Camp Hill, PA 17011-4518
Phone (717) 761-8900

308 Hockersville Rd
Hershey, PA 17033-2080
Phone (717) 298-1411

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.36 of 100Reported as group
Quality
56.69
Promoting interoperability
100
Improvement activities
40
Cost
74.52

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD460966PAMDFamily Medicine Physician
MT206104PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
The Milton S Hershey Medical Center Physician Group CurrentSince Jul 17, 2017 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Family Medicine CurrentSince Jul 17, 2017 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients
The Milton S. Hershey Medical Center Physicians Group Family Medicine Past Accepting new patients
The Milton S Hershey Medical Center Past Accepting new patients

Locations

3025 Market St
Camp Hill, PA 17011
Phone (717) 691-1212

3025 Market St
Ste B
Camp Hill, PA 17011
Phone (717) 691-1212

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

Organizations & group practices 6

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 11

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": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1245643956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 858",
            "address_2": "MC 410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170330858",
            "telephone_number": "800-243-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 MARKET ST STE B",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170114518",
            "telephone_number": "717-691-1212",
            "fax_number": "717-691-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVARAJ",
        "first_name": "TARA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT206104",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD460966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Hill, PA

Sources for this page

Verify at the official NPI Registry.