Individual provider Active NPI

Tara Lynne Weaver, CRNP

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1467083063
Registry record updated Feb 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP021372 Issued in PA
Practice address
800 Walnut St FL 18
Philadelphia, PA 19107-5176
Phone
(215) 316-5151
NPI assigned
Feb 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP021372 PA Primary

Addresses

Primary practice location

800 Walnut St FL 18
Philadelphia, PA 19107-5176

Mailing address

226 McClellan St
Philadelphia, PA 19148-1919
Phone (215) 593-0205

Other names 1

  • Ms. Tara Lynne Martin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20200421000097 PA Practitioner - Nurse Practitioner 8527498203 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, shared by 15 NPIs, 3,433 clinicians

Practice addresses (Care Compare)

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-2777

Hospital & facility affiliations

  • Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP021372PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group CurrentSince Mar 23, 2020 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Mar 23, 2020 Accepting new patients
University of Penn - Medical Group CurrentSince Dec 9, 2020 Accepting new patients

Locations

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3737 Market St
Fl 3
Philadelphia, PA 19104
Phone (215) 662-2775

800 Walnut St
Fl 18
Philadelphia, PA 19107
Phone (215) 289-5180

Organizations & group practices 4

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 4

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": "1580515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580515200000",
    "number": "1467083063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 MCCLELLAN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191481919",
            "telephone_number": "215-593-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WALNUT ST FL 18",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075176",
            "telephone_number": "215-316-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "TARA",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-01",
        "last_updated": "2020-02-01",
        "certification_date": "2020-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP021372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "MARTIN",
            "middle_name": "LYNNE",
            "prefix": "MS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.