Tara Kopp Bastek, M.D.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

9900162 Issued in NC

Practice address

3000 New Bern Ave
Neonatology Dept.
Raleigh, NC 27610-1231

Phone

(919) 350-8545

Fax

(919) 350-8146

NPI assigned

Aug 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Tara Kopp Former name

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tbastek12834@directhisp.wakemed.org

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.

• Wakemed Specialists Group, LLC

  • Cardiovascular Disease Physician
  • Raleigh, NC
  • NPI 1588227839
  Medicare reassignment NPD
• Wakemed Specialists Group LLC

  • Cardiac Rehabilitation Registered Nurse
  • Raleigh, NC
  • NPI 1063304228
  NPD
• Wakemed Specialists Group, LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Raleigh, NC
  • NPI 1538723184
  NPD
• Wakemed Faculty Practice Plan

  • Pediatric Critical Care Medicine Physician
  • Raleigh, NC
  • NPI 1013203819

  Neonatal-Perinatal Medicine

  NPD (past)
• Wakemed Faculty Practice Plan

  • Surgery Physician
  • Raleigh, NC
  • NPI 1396791786

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268352000000",
    "number": "1316956774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 NEW BERN AVE",
            "address_2": "SUITE 300",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101247",
            "telephone_number": "919-350-8228",
            "fax_number": "919-350-7976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 NEW BERN AVE",
            "address_2": "NEONATOLOGY DEPT.",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101231",
            "telephone_number": "919-350-8545",
            "fax_number": "919-350-8146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTEK",
        "first_name": "TARA",
        "middle_name": "KOPP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2010-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "9900162",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NC",
            "license": "9900162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891203C",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "KOPP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Surabhi Bassin, PT
• Bassiri Eye Care OD, PA
• Hoda Imeni Bassiri, D.D.S.
• Kiarash Bassiri, O.D.
• Jessica Bast, PT
• Karley Elizabeth Bastien, FNP-C
• Kristina Marie Bastone-Baker, LCMHC, NCC
• Joy Bataille, RPH
• Deirdre Vance Batch, M.D. MPH.
• Stephanie Batchelor, LCSWA

• Neonatal-Perinatal Medicine Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Neonatal-Perinatal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2010; 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.