NPIMap

Individual provider Active NPI

Tarajo Hanrahan, MD

  • Family Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1295256063
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4351039051 Issued in MI
Practice address
300 Lafayette Ave SE Ste 4000
Grand Rapids, MI 49503-4692
Phone
(616) 685-6922
NPI assigned
Jul 3, 2017
Last updated
Jan 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301112370 MI
Family Medicine Physician 207Q00000X 4351039051 MI Primary

Addresses

Primary practice location

300 Lafayette Ave SE Ste 4000
Grand Rapids, MI 49503-4692

Mailing address

300 Lafayette Ave SE Ste 4000
Grand Rapids, MI 49503-4692

Other names 1

  • Tarajo Reinhart Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20190910000123 MI Practitioner - Family Practice 6507137015 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Physician NetworkGroup PAC ID 8921996307, 109 clinicians

Practice addresses (Care Compare)

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone (616) 685-5000

2006 Holton Rd
Muskegon, MI 49445-1505
Phone (231) 672-3333

3570 Henry St
Norton Shores, MI 49441-4576

Hospital & facility affiliations

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
4351039051MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary's Medical Group CurrentSince Nov 4, 2020 Accepting new patients
Mercy Physician Network Family Medicine CurrentSince Sep 1, 2020 Accepting new patients
Advantage Health/Saint Mary's Medical Group Current Accepting new patients
Mercy Specialty Services CurrentSince Nov 1, 2020 Accepting new patients
Mercy Physician Network Family Medicine CurrentSince Sep 1, 2020 Accepting new patients
Advantage Health Saint Mary's Medical Group CurrentSince Nov 4, 2020 Accepting new patients
Mercy Health Partners PastSince Sep 7, 2021 Accepting new patients
Saint Mary's Health Services Past Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

200 Jefferson Ave SE
Grand Rapids, MI 49503
Phone (616) 685-5000

300 Lafayette Ave SE
Ste 4000
Grand Rapids, MI 49503
Phone (616) 685-6741

1500 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3027

2006 Holton Rd
North Muskegon, MI 49445
Phone (231) 672-3333

3570 Henry St
Ste 220
Norton Shores, MI 49441
Phone (231) 672-3155

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13864/brand/1/csg/1/fhir/r4

Organizations & group practices 8

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 3

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": "1499040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1295256063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LAFAYETTE AVE SE STE 4000",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LAFAYETTE AVE SE STE 4000",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034692",
            "telephone_number": "616-685-6922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANRAHAN",
        "first_name": "TARAJO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-03",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301112370",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4351039051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARAJO",
            "last_name": "REINHART",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.