Tara Kazemfar, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-5290 Issued in ID

Practice address

621 Main St Ste a
Lewiston, ID 83501-1871

Phone

(509) 769-7551

Fax

(509) 254-5018

NPI assigned

Aug 6, 2019

Last updated

Dec 11, 2023By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Dynamic Physical Therapy PLLC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Lewiston, ID
  • NPI 1619360245
  Medicare reassignment NPD
• Performance Physio PLLC

  dba Performance Health and Wellness

  • Physical Therapy Clinic/Center
  • Lewiston, ID
  • NPI 1073097390
  Medicare reassignment NPD

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1356996391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 MAIN ST STE A",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835011871",
            "telephone_number": "509-769-7551",
            "fax_number": "509-254-5018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 MAIN ST STE A",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835011871",
            "telephone_number": "509-769-7551",
            "fax_number": "509-254-5018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZEMFAR",
        "first_name": "TARA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-06",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-5290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason John Jungert
• Arnold Kadrmas, M.D.
• Lisa L Kaltenbaugh, CRNFA
• Barbara A. Kammer
• K'Lee Lynae Kasper, BSN, RN, IBCLC
• Mark R Keane, M.D.
• Leroy Neal Keene, PAC
• Lauren Keeney
• Justin D Keller, D.C.
• Kelley Kids Ranch, LLC

• Physical Therapist in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.