Individual provider Active NPI

Tara Neary, MD

  • Pediatrics Physician
  • Hartford, CT
National Provider Identifier
1487151296
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
79658 Issued in CT
Practice address
76 New Britain Ave
Hartford, CT 06106-3305
Phone
(860) 545-9300
NPI assigned
Apr 9, 2018
Last updated
Nov 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X PENDING DC
Pediatrics Physician 208000000X 79658 CT Primary

Addresses

Primary practice location

76 New Britain Ave
Hartford, CT 06106-3305

Mailing address

19 Grand St
Middletown, CT 06457-2705
Phone (860) 347-6971

Other practice location 1

111 Michigan Ave NW
Washington, DC 20010-2916
Phone (202) 476-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20241112003121 CT Practitioner - Pediatric Medicine 1254736754 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
79658CTMDPediatrics Physician
PENDINGDCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center Inc CurrentSince Nov 4, 2024 Accepting new patients
Community Health Center Inc Pediatrics CurrentSince Nov 4, 2024 Accepting new patients

Locations

76 New Britain Ave
Hartford, CT 06106
Phone (860) 545-9300

19 Grand St
Middletown, CT 06457
Phone (860) 323-0172

Interoperability endpoints

  • Direct secure messaging: tara.neary@chcict.eclinicaldirectplus.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1487151296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 GRAND ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572705",
            "telephone_number": "860-347-6971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 NEW BRITAIN AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063305",
            "telephone_number": "860-545-9300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Michigan Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200102916",
            "country_code": "US",
            "telephone_number": "202-476-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEARY",
        "first_name": "TARA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DC",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "79658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.