Individual provider Active NPI

Tara L Stewart, M.D.

  • Dermatology Physician
  • Burlington, NC
National Provider Identifier
1417043647
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
9900357 Issued in NC
Practice address
1734 Westbrook Ave
Burlington, NC 27215-8721
Phone
(336) 584-5801
Fax
(336) 584-5860
NPI assigned
Oct 5, 2006
Last updated
Mar 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 9900357 NC Primary

Addresses

Primary practice location

1734 Westbrook Ave
Burlington, NC 27215-8721

Mailing address

1734 Westbrook Ave
Burlington, NC 27215-8721
Phone (336) 584-5801

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tstewart291514@direct.conehealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20111108000035 NC Practitioner - Dermatology 4688847627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Utah School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1734 Westbrook Ave
Burlington, NC 27215-8721
Phone (336) 584-5801

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions393
Removal or shaving of skin growth33
Skin biopsy17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Moses Cone Physician Services, Inc. Current Accepting new patients
Moses Cone Physician Services, Inc. Past Accepting new patients

Locations

1734 Westbrook Ave
Burlington, NC 27215
Phone (336) 584-5801

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

301 E Wendover Ave
Ste 411
Greensboro, NC 27401
Phone (336) 832-3200

Interoperability endpoints

  • Direct secure messaging: tstewart291514@direct.conehealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1417043647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1734 WESTBROOK AVE",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272158721",
            "telephone_number": "336-584-5801",
            "fax_number": "336-584-5860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1734 WESTBROOK AVE",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272158721",
            "telephone_number": "336-584-5801",
            "fax_number": "336-584-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "TARA",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "9900357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tstewart291514@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Health Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1734 Westbrook Ave",
            "city": "Burlington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "272158721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Burlington, NC

Sources for this page

Verify at the official NPI Registry.