Individual provider Active NPI

Tara Loreth Varoni, DO

  • Family Medicine Physician
  • Escanaba, MI
National Provider Identifier
1265728729
Registry record updated Sep 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101019305 Issued in MI
Practice address
710 S Lincoln Rd
Suite 100
Escanaba, MI 49829-1292
Phone
(906) 786-4628
NPI assigned
Jun 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2014

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
Family Medicine Physician 207Q00000X 5101019305 MI Primary

Addresses

Primary practice location

710 S Lincoln Rd
Suite 100
Escanaba, MI 49829-1292

Mailing address

26374 Network PL
Chicago, IL 60673-1263
Phone (906) 225-3630

Other identifiers 1

IdentifierTypeStateIssuer
1265728729MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20130814000495 MI Practitioner - Family Practice 1759523111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1414 W Fair Ave
Marquette, MI 49855-2675

710 S Lincoln Rd
Escanaba, MI 49829-1293

Hospital & facility affiliations

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 Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Marquette Physician Practices Inc Family Medicine CurrentSince May 1, 2013 Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince May 1, 2013 Accepting new patients
DLP Marquette Physician Practices Inc Past Accepting new patients

Locations

710 S Lincoln Rd
Ste 100
Escanaba, MI 49829
Phone (906) 786-4628

1414 W Fair Ave
Ste 36
Marquette, MI 49855
Phone (906) 225-3864

Interoperability endpoints

  • Direct secure messaging: tara.varoni.1@8233.direct.athenahealth.com

Organizations & group practices 3

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 4

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": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410739200000",
    "number": "1265728729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26374 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731263",
            "telephone_number": "906-225-3630",
            "fax_number": "906-225-4537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 S LINCOLN RD",
            "address_2": "SUITE 100",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498291292",
            "telephone_number": "906-786-4628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARONI",
        "first_name": "TARA",
        "middle_name": "LORETH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2014-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101019305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265728729",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Escanaba, MI

Sources for this page

Verify at the official NPI Registry.