Maraposa Surgical Inc.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

MD419351 Issued in PA

Legal business name

MARAPOSA SURGICAL INC.

Practice address

900 Chestnut Street Ext
Ste a
Bradford, PA 16701-2298

Phone

(814) 368-8490

Fax

(814) 368-8041

NPI assigned

Sep 3, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Robert Wayne Tahara, M.D.NPI 1902859069

Title

President

Phone

(814) 368-8490

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Tahara, MD

  • Vascular Surgery Physician
  • Bradford, PA
  • NPI 1902859069
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458691200000",
    "number": "1508014697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CHESTNUT STREET EXT",
            "address_2": "STE A",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167012298",
            "telephone_number": "814-368-8490",
            "fax_number": "814-368-8041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 CHESTNUT STREET EXT",
            "address_2": "STE A",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167012298",
            "telephone_number": "814-368-8490",
            "fax_number": "814-368-8041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARAPOSA SURGICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-03",
        "last_updated": "2016-03-23",
        "status": "A",
        "authorized_official_last_name": "TAHARA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-368-8490",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD419351",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "MD419351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luis C Gonzalez MD
• Lynn Lunn
• Alliyson Marie Maduri, M.S., SLP-CCC/L
• Asim Makhdom, MD
• James Mancini, DDS
• Maria Fisher Enix
• Nicole Marker-Zewe, CRNP
• Jeana Marquez
• Luis B Marrero, MD
• Erica Nicole Marshall

• Vascular Surgery Physician in Bradford, PA
• Providers in Bradford, PA by specialty
• Vascular Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.