Tara L. Sullivan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

5072 Issued in MA

Practice address

245 Center St
Auburn, ME 04210-6169

Phone

(207) 786-2500

Fax

(207) 786-2503

NPI assigned

Jul 31, 2016

Last updated

Jul 26, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

New England College of Optometry, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Riverside Eye Center, PAGroup PAC ID 0840266342, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tsullivan@riverside.direct.eyemdemr.com

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.

• Riverside Eye Center PA

  • Ophthalmology Physician
  • Lewiston, ME
  • NPI 1780879510
  Medicare reassignment Care Compare group NPD
• Riverside Eye Center PA

  • Ambulatory Surgical Clinic/Center
  • Lewiston, ME
  • NPI 1396427407
  NPD

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

{
    "created_epoch": "1469923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1518410133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 LISBON ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407418",
            "telephone_number": "207-786-2500",
            "fax_number": "207-786-2503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 CENTER ST",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042106169",
            "telephone_number": "207-786-2500",
            "fax_number": "207-786-2503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "193 Main St",
            "address_purpose": "LOCATION",
            "city": "Norway",
            "state": "ME",
            "postal_code": "042685645",
            "country_code": "US",
            "telephone_number": "207-743-0027",
            "fax_number": "207-743-0051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "TARA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-31",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Edwin Strauss, D.O.
• David J Stuchiner, M.D.
• Anthony Sullivan, PHARMD
• Jennifer Sullivan, CNP
• Martina M Sullivan, MSW
• Sunshine Behavior Consulting
• Sweet Song Services
• Hunter Lee William Sweet, D.O.
• Alyson Kate Sylvester
• Abigail Symbol

• Optometrist in Auburn, ME
• Providers in Auburn, ME by specialty
• Optometrist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; 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.