Tara Marie Frye, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

C50011410 Issued in DE

Practice address

78 Omega Dr BLDG C
Newark, DE 19713-2064

Phone

(302) 368-2883

Fax

(302) 368-2892

NPI assigned

Jul 6, 2020

Last updated

Nov 16, 2020By 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 2

Addresses

Other identifiers 1

Other names 1

• Tara Marie Keller Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in DE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Infectious Disease Associates PAGroup PAC ID 1052337201, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christiana Hospital Hospital, Newark, DE, CCN 080001
• Bayhealth Medical Center, Kent Campus Hospital, Dover, DE, CCN 080004

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Infectious Disease Associates PA

  • Infectious Disease Physician
  • Newark, DE
  • NPI 1205904679
  Medicare reassignment Care Compare group
• Brain Spa de LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wilmington, DE
  • NPI 1861081499
  NPD (past)

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

• Bayhealth Medical Center, Inc.

  dba Bayhealth Hospital, Kent Campus

  • General Acute Care Hospital
  • Dover, DE
  • NPI 1467546135
  Care Compare affiliation
• Christiana Care Health Services, Inc.

  dba Christiana Care

  • General Acute Care Hospital
  • Wilmington, DE
  • NPI 1134194038
  Care Compare affiliation

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1417575549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 OMEGA DR BLDG C",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132064",
            "telephone_number": "302-368-2883",
            "fax_number": "302-368-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 OMEGA DR BLDG C",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132064",
            "telephone_number": "302-368-2883",
            "fax_number": "302-368-2892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYE",
        "first_name": "TARA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DE",
            "license": "C50011410",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DE",
            "license": "C5-0011410",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "C50011410",
            "state": "DE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tarakeller@ida.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "EHR email address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "78 Omega Dr Bldg C",
            "city": "Newark",
            "state": "DE",
            "country_code": "US",
            "postal_code": "197132064",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tarafrye@ida.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Allscripts Email Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "78 Omega Dr Bldg C",
            "city": "Newark",
            "state": "DE",
            "country_code": "US",
            "postal_code": "197132064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "KELLER",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David L Frieswyk, PA-C
• Andriana Frost, PSYD
• Christopher Frost, DPT
• Melissa Frost
• Kelsey Fryberger, FNP-C
• FS Tenant Pool I Trust (Millcroft Retirement Community)
• Gerard Fulda, MD
• Denise F Fuller, LCSW
• Susan Fullerton, MSN
• Joseph Fullum

• Medical Physician Assistant in Newark, DE
• Providers in Newark, DE by specialty
• Medical Physician Assistant in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; 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.