Tara Lynn Lassila, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601007849 Issued in MI

Practice address

500 Campus Dr
Hancock, MI 49930-1569

Phone

(906) 483-1000

Fax

(906) 483-1147

NPI assigned

Jan 11, 2008

Last updated

Jul 21, 2016By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MI

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Portage Physician Practices IncGroup PAC ID 6103053509, 56 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Up Health System Portage Hospital, Hancock, MI, CCN 230108

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Portage Physician Practices Inc

  • Internal Medicine Physician
  • Hancock, MI
  • NPI 1225461684
  Medicare reassignment Care Compare group
• Portage Hospital LLC

  dba UP Health System Portage

  • General Acute Care Hospital
  • Hancock, MI
  • NPI 1245667229
  Medicare reassignment
• Portage Physician Practices Inc.

  dba Portage Health Express Care

  • Family Medicine Physician
  • Houghton, MI
  • NPI 1679902191
  NPD
• Portage Hospital LLC

  dba Portage Health

  • Medicare Defined Swing Bed Hospital Unit
  • Hancock, MI
  • NPI 1821425612
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Portage Hospital LLC

  dba UP Health System Portage

  • General Acute Care Hospital
  • Hancock, MI
  • NPI 1245667229
  Care Compare affiliation

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1356527063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CAMPUS DR",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301569",
            "telephone_number": "906-483-1000",
            "fax_number": "906-483-1147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CAMPUS DR",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301569",
            "telephone_number": "906-483-1000",
            "fax_number": "906-483-1147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASSILA",
        "first_name": "TARA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-11",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007849",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "TL955786",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "0C16002",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elissa Johnson Labyak, PT
• Taylor Landers, CNM
• John D Lang, MD
• Violeta Lara, MD
• Nathan Larson, MS, AT, ATC
• Leonard W. Beesley, DDS
• Ann Lepisto, RDH
• Zoe Michelle Lincoln, LPC
• Audrey Liston, DO
• William Liston, DO

• Physician Assistant in Hancock, MI
• Providers in Hancock, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; 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.