Individual provider Active NPI

Tari L Roche, DO

  • Family Medicine Physician
  • Anacortes, WA
National Provider Identifier
1528080678
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP00001743 Issued in WA
Practice address
2511 M Ave B
Anacortes, WA 98221-3897
Phone
(360) 299-4211
Fax
(360) 299-4213
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP00001743 WA Primary

Addresses

Primary practice location

2511 M Ave B
Anacortes, WA 98221-3897

Mailing address

1211 24TH St
Anacortes, WA 98221-2562
Phone (360) 299-4216

Other identifiers 1

IdentifierTypeStateIssuer
8290066MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20100316000209 WA Practitioner - Family PracticePractitioner - Other (Physician) 3173658135 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District No 2 Skagit County Washington Current Accepting new patients
Public Hospital District No 2 Skagit County Washington CurrentSince Apr 28, 2019 Accepting new patients

Locations

1213 24th St
Ste 100
Anacortes, WA 98221
Phone (360) 293-3101

2511 M Ave
Ste B
Anacortes, WA 98221
Phone (360) 293-3101

1211 24th St
Anacortes, WA 98221
Phone (360) 293-3181

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1528080678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 24TH ST",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982212562",
            "telephone_number": "360-299-4216",
            "fax_number": "360-299-1369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 M AVE B",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982213897",
            "telephone_number": "360-299-4211",
            "fax_number": "360-299-4213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCHE",
        "first_name": "TARI",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00001743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8290066",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anacortes, WA

Sources for this page

Verify at the official NPI Registry.