Individual provider Active NPI

Tara Griffith

  • Physician Assistant
  • Tallahassee, FL
National Provider Identifier
1417760588
Registry record updated Apr 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1300 Miccosukee Rd
Tallahassee, FL 32308-5054
Phone
(850) 431-1155
NPI assigned
Jan 31, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1300 Miccosukee Rd
Tallahassee, FL 32308-5054

Mailing address

12856 Bonaparte Ave
Los Angeles, CA 90066-6526

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250401000998 FL Practitioner - Physician Assistant 8921521840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1300 Miccosukee Rd
Tallahassee, FL 32308-5054
Phone (850) 431-1155

1401 Centerville Rd
Tallahassee, FL 32308-4639

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Memorial Healthcare Inc CurrentSince Apr 1, 2025 Accepting new patients
Tallahassee Memorial Healthcare Inc CurrentSince Apr 1, 2025 Accepting new patients

Locations

15 Council Moore Rd
Crawfordville, FL 32327
Phone (850) 926-7105

1401 Centerville Rd
Ste 400
Tallahassee, FL 32308
Phone (850) 431-3360

2473 Care Dr
Ste 102
Tallahassee, FL 32308
Phone (850) 320-6054

1607 Saint James Ct
Ste 1
Tallahassee, FL 32308
Phone (850) 431-7021

1300 Miccosukee Rd
Tallahassee, FL 32308
Phone (850) 431-1155

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1738281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744502400000",
    "number": "1417760588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12856 BONAPARTE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900666526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MICCOSUKEE RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085054",
            "telephone_number": "850-431-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFITH",
        "first_name": "TARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-31",
        "last_updated": "2025-04-13",
        "certification_date": "2025-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.