Tara L Deso, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

RN284675 Issued in MA

Practice address

385 Grove St
Worcester, MA 01605-3924

Phone

(508) 595-2000

Fax

(508) 853-7149

NPI assigned

Jul 29, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tara L McCue Former name

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tara.deso.npi1306490396.reliant@direct.optumcare.masshiway.net

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.

• Reliant Medical Group, Inc

  • Family Medicine Physician
  • Worcester, MA
  • NPI 1720017528
  Medicare reassignment NPD
• Regis College

  • Dental Clinic/Center
  • Newton, MA
  • NPI 1982171849
  NPD (past)

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1306490396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 NEPONSET ST",
            "address_2": "WOT 2ND FL, STE C203",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062714",
            "telephone_number": "508-595-2000",
            "fax_number": "508-853-7149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 GROVE ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016053924",
            "telephone_number": "508-595-2000",
            "fax_number": "508-853-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESO",
        "first_name": "TARA",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-29",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN284675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110158765A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "MCCUE",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katrina Desjarlais
• Sarah Ellen Deslauriers
• Brittany Desmarais
• Anthony James Desmond, PHARMD, RPH
• Amanda G. K. Desnoyers, PA-C
• Isabela O Desouza
• Lesley Desriviere, MD
• Tracy Ann Desruisseaux, LADC
• Nicole Marie Destefano
• Destiny Givers Afc LLC

• Gerontology Nurse Practitioner in Worcester, MA
• Providers in Worcester, MA by specialty
• Gerontology Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.