Tara D Bournay, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101020245 Issued in MI

Practice address

3601 W Front St
Traverse City, MI 49684-8151

Phone

(231) 946-1120

Fax

(231) 946-8943

NPI assigned

May 14, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tara A Dell Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Family Practice

Education

Michigan State University College of Osteopathic Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Partners in Family Practice PCGroup PAC ID 7719990738, 3 clinicians

Great Lakes Therapy Housecalls PCGroup PAC ID 7719876580, shared by 2 NPIs, 71 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Munson Medical Center Hospital, Traverse City, MI, CCN 230097
• Kalkaska Memorial Health Center Hospital, Kalkaska, MI, CCN 231301
• Munson Healthcare Cadillac Hospital Hospital, Cadillac, MI, CCN 230081
• Paul Oliver Memorial Hospital Hospital, Frankfort, MI, CCN 231300

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tara.bournay@pifp.eclinicaldirectplus.com

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.

• Partners in Family Practice, P.C.

  • Family Medicine Physician
  • Traverse City, MI
  • NPI 1437187093

  MI

  Medicare reassignment Care Compare group
• Munson Medical Center

  • Endocrinology, Diabetes & Metabolism Physician
  • Traverse City, MI
  • NPI 1083761860

  MI

  Medicare reassignment NPD
• Munson Medical Group

  • Cardiovascular Disease Physician
  • Traverse City, MI
  • NPI 1821398322

  MI

  Medicare reassignment NPD
• Munson Medical Center

  • Psychiatric Hospital Unit
  • Traverse City, MI
  • NPI 1891586103
  NPD
• Munson Medical Center

  • Family Medicine Physician
  • Traverse City, MI
  • NPI 1922030162

  Family Medicine

  NPD
• Munson Medical Group

  • Geriatric Medicine (Internal Medicine) Physician
  • Traverse City, MI
  • NPI 1326801440
  NPD
• Munson Medical Group

  • Family Medicine Physician
  • Traverse City, MI
  • NPI 1861047060

  Family Medicine

  NPD

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

• Kalkaska Memorial Health Center

  • Critical Access Hospital
  • Kalkaska, MI
  • NPI 1497751309

  Hospital

  Care Compare affiliation
• Munson Healthcare Cadillac

  • Family Medicine Physician
  • Cadillac, MI
  • NPI 1487051611

  Hospital

  Care Compare affiliation
• Munson Healthcare Cadillac

  • General Acute Care Hospital
  • Cadillac, MI
  • NPI 1841696754

  Hospital

  Care Compare affiliation
• Munson Medical Center

  • General Acute Care Hospital
  • Traverse City, MI
  • NPI 1952307852

  Hospital

  Care Compare affiliation
• Paul Oliver Memorial Hospital

  • Critical Access Hospital
  • Frankfort, MI
  • NPI 1427054360

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1487090718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 W FRONT ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848151",
            "telephone_number": "231-946-1120",
            "fax_number": "231-946-8943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W FRONT ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848151",
            "telephone_number": "231-946-1120",
            "fax_number": "231-946-8943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURNAY",
        "first_name": "TARA",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-14",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101020245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY HEALTH",
            "identifier": "900001556",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tara.bournay@pifp.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3601 W Front St",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496848151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "DELL",
            "middle_name": "A",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Rose Bott, ATC
• Jonathan E. Bott, MD
• Chloe Boudjalis
• Brandon Bourdon
• Sherri Ann Bourgeois
• Chad Thomas Bousamra, M.A.
• Anthony J Bouwhuis, CPO
• Karah Nicole Bowen
• Barbara Sue Bowerman, MSW
• Jennifer L. Bowerman, M.D.

• Family Medicine Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.