Individual provider Active NPI

Tara Danielle Harris, MD

  • Hospitalist Physician
  • Coral Gables, FL
National Provider Identifier
1306089396
Registry record updated Mar 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
ME113247 Issued in FL
Practice address
5955 Ponce de Leon Blvd.
Coral Gables, FL 33146
Phone
(305) 661-1515
Fax
(305) 662-3723
NPI assigned
Apr 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME113247 FL
Pediatric Critical Care Medicine Physician 2080P0203X ME113247 FL
Hospitalist Physician 208M00000X ME113247 FL Primary

Addresses

Primary practice location

5955 Ponce de Leon Blvd.
Coral Gables, FL 33146

Mailing address

5955 Ponce de Leon Blvd.
Coral Gables, FL 33146
Phone (305) 661-1515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150807013230 FL Practitioner - Pediatric Medicine 5799099586 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME113247FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kidz Medical Services, Inc Pediatric Critical Care Medicine CurrentSince Jul 24, 2013 Accepting new patients
Kidz Medical Services, Inc CurrentSince Jul 24, 2013 Accepting new patients

Locations

9980 Central Park Blvd N
Ste 318
Boca Raton, FL 33428
Phone (561) 451-0500

5955 Ponce de Leon Blvd
Coral Gables, FL 33146
Phone (305) 662-8668

975 Baptist Way
Ste 203
Homestead, FL 33033
Phone (305) 242-8200

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1239062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1306089396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 PONCE DE LEON BLVD.",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "33146",
            "telephone_number": "305-661-1515",
            "fax_number": "305-662-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 PONCE DE LEON BLVD.",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "33146",
            "telephone_number": "305-661-1515",
            "fax_number": "305-662-3723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "TARA",
        "middle_name": "DANIELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-07",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME113247",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "ME113247",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME113247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.