Tara Marie Stewart, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA09071 Issued in TX

Practice address

11521 N Ranch Road 620 Ste 100
Austin, TX 78726-1112

Phone

(512) 402-6830

NPI assigned

Oct 10, 2012

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 names 1

• Tara Marie Hodge Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Privia Medical Group Gulf Coast PLLCGroup PAC ID 4688999022, 511 clinicians

St Davids Carenow Urgent Care PLLCGroup PAC ID 4284918418, 101 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tara.stewart.1@8042.direct.athenahealth.com

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.

• Privia Medical Group Gulf Coast, PLLC

  • Obstetrics & Gynecology Physician
  • Houston, TX
  • NPI 1578969465
  Medicare reassignment Care Compare group NPD
• St. David'S Carenow Urgent Care PLLC

  • Family Medicine Physician
  • Austin, TX
  • NPI 1851844104
  Medicare reassignment Care Compare group
• Privia Medical Group Gulf Coast PLLC

  • Interventional Pain Medicine Physician
  • San Antonio, TX
  • NPI 1457167033
  NPD

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

{
    "created_epoch": "1349827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1346592615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11521 N RANCH ROAD 620 STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787261112",
            "telephone_number": "512-402-6830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11521 N RANCH ROAD 620 STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787261112",
            "telephone_number": "512-402-6830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11355 Pembrooke Sq",
            "address_2": "108A",
            "address_purpose": "LOCATION",
            "city": "Waldorf",
            "state": "MD",
            "postal_code": "206034805",
            "country_code": "US",
            "telephone_number": "240-252-2140",
            "fax_number": "240-252-2141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEWART",
        "first_name": "TARA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-10",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C04875",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "HODGE",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Naidene Stewart
• Nickolas Stewart
• Nicole Marie Stewart
• Paige Stewart
• Robert B Stewart, PHARM.D.
• Thomas Derin Stewart
• STH, PLLC
• Kayla Brooke Stibley, MS, RDN, LD
• Erin Jessica Stibral, P.A.- C
• Jimmy L Stickles, MD

• Physician Assistant in Austin, TX
• Providers in Austin, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.