Michael E Tavernaris, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME116308 Issued in FL

Practice address

1817 Lewis Turner Blvd Ste F
Fort Walton Beach, FL 32547-1349

Phone

(850) 396-1110

Fax

(850) 466-0950

NPI assigned

Apr 30, 2009

Last updated

Sep 27, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Family PracticeAlso: Sports Medicine

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Fort Walton-Destin Hospital Hospital, Fort Walton Beach, FL, CCN 100223

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Coastline Medical Services PLLC

  • Medical Specialty Clinic/Center
  • Fort Walton Beach, FL
  • NPI 1003361767
  Medicare reassignment Authorized official
• Capital Regional Heart Associates, LLC

  • Cardiovascular Disease Physician
  • Tallahassee, FL
  • NPI 1992043509
  NPD (past)

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

• Fort Walton Beach Medical Center, Inc.

  dba HCA Florida Fort Walton-Destin Hospital

  • General Acute Care Hospital
  • Fort Walton Beach, FL
  • NPI 1639128820
  Care Compare affiliation

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

{
    "created_epoch": "1241049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1386888626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 MARY ESTHER BLVD",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325691687",
            "telephone_number": "850-396-1110",
            "fax_number": "850-466-0950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 LEWIS TURNER BLVD STE F",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471349",
            "telephone_number": "850-396-1110",
            "fax_number": "850-466-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVERNARIS",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-30",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME116308",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "MD31989",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "ME116308",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "AL",
            "license": "MD31989",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassandra Tang
• Tara Harden M.D., P.a.
• Paul Tartarilla, APRN
• Mary Miller Tatum, M.ED, CCC-SLP
• Sherry Jane Tavarez, RN
• Amanda Taylor, LMT
• Camella M Taylor
• Hannah Taylor, NP-C
• Jeannine Torres Taylor, CRNA
• Julia Hall Taylor, ISW, MSW

• Family Medicine Physician in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.