Tara Frazer

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501017030 Issued in MI

Practice address

25755 Telegraph Rd
Brownstown, MI 48134-1013

Phone

(734) 782-7003

Fax

(734) 782-7005

NPI assigned

Nov 21, 2014

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Precision Orthopedics PCGroup PAC ID 6406859479, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Precision Orthopedics PC

  • Medical Specialty Clinic/Center
  • Brownstown TWP, MI
  • NPI 1538198700
  Medicare reassignment Care Compare group NPD
• Michigan Sports and Spine Center PC

  • Physical Medicine & Rehabilitation Physician
  • Livonia, MI
  • NPI 1205887262
  Medicare reassignment NPD

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

{
    "created_epoch": "1416528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1396142287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE",
            "address_2": "SUITE 104",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480354258",
            "telephone_number": "586-416-9100",
            "fax_number": "586-416-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25755 TELEGRAPH RD",
            "city": "BROWNSTOWN",
            "state": "MI",
            "postal_code": "481341013",
            "telephone_number": "734-782-7003",
            "fax_number": "734-782-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZER",
        "first_name": "TARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-21",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501017030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "0P33780",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1538198700",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "5501017030",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND PTAN",
            "identifier": "P33780004",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Brownstown, MI
• Providers in Brownstown, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; 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.