NPIMap

Individual provider Active NPI

Tara L. Stump, PA

  • Physician Assistant
  • Charlottesville, VA
National Provider Identifier
1417316431
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110005225 Issued in VA
Practice address
1215 Lee St
2ND Floor
Charlottesville, VA 22908-0001
Phone
(434) 243-4520
Fax
(434) 982-1998
NPI assigned
Feb 18, 2016
Last updated
Mar 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0110005225 VA
Physician Assistant 363A00000X 0110005225 VA Primary

Addresses

Primary practice location

1215 Lee St
2ND Floor
Charlottesville, VA 22908-0001

Mailing address

PO Box 9007
Charlottesville, VA 22906-9007

Other practice location 1

5875 Bremo Rd Ste 400B
Richmond, VA 23226-1928
Phone (804) 287-7840

Other names 1

  • Tara L. Deacon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160420000424 VA Practitioner - Physician Assistant 9133427404 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1510 N 28TH St
Richmond, VA 23223-5311

5801 Bremo Rd
Richmond, VA 23226-1907
Phone (804) 764-6000

8220 Meadowbridge Rd
Suite 101
Mechanicsville, VA 23116-2336
Phone (804) 288-2673

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.45 of 100Reported as group
Quality
79.76
Promoting interoperability
100
Improvement activities
40
Cost
75.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110005225VAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Feb 19, 2016 Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Mar 23, 2025 Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Mar 23, 2025 Accepting new patients

Locations

1215 Lee St
Fl 2
Charlottesville, VA 22908
Phone (434) 243-4520

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

1510 N 28th St
Ste 110
Richmond, VA 23223
Phone (804) 545-2304

5875 Bremo Rd
Ste 400B
Richmond, VA 23226
Phone (804) 287-7690

Interoperability endpoints

  • Direct secure messaging: tstump2792747@direct.bsmhealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1455753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1417316431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "address_2": "2ND FLOOR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080001",
            "telephone_number": "434-243-4520",
            "fax_number": "434-982-1998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5875 Bremo Rd Ste 400B",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232261928",
            "country_code": "US",
            "telephone_number": "804-287-7840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUMP",
        "first_name": "TARA",
        "middle_name": "L.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-18",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110005225",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110005225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "DEACON",
            "middle_name": "L.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.