Tara Leigh Clancy, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

20A 9695 Issued in CA

Practice address

2375 S Melrose Dr
Vista, CA 92081-8788

Phone

(760) 305-1900

Fax

(760) 305-1910

NPI assigned

Jan 17, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Internal Medicine

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

John H Clancy DO and Tara Leigh Clancy DO Medical CorporationGroup PAC ID 0547485419, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: tara.clancy.1@11800.direct.athenahealth.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.

• John H Clancy DO and Tara Leigh Clancy DO Medical Corporation

  • Internal Medicine Physician
  • Vista, CA
  • NPI 1053722124
  Medicare reassignment Care Compare group NPD
• Surgical Consultants of Joliet, LTD

  • Surgery Physician
  • Joliet, IL
  • NPI 1467461277
  NPD (past)

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

{
    "created_epoch": "1389916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542585600000",
    "number": "1588086003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2375 S MELROSE DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920818788",
            "telephone_number": "760-305-1900",
            "fax_number": "760-305-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 S MELROSE DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920818788",
            "telephone_number": "760-305-1900",
            "fax_number": "760-305-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLANCY",
        "first_name": "TARA",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-17",
        "last_updated": "2018-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A 9695",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A 9695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khin-Poh Oscar Chung, O.D.
• Jessica Cincotta
• Calin Cionca
• City of Vista California
• John Clancy, DO
• Belinda T Clanor, D.O.
• Cynthia Rae Clark, F.N.P.
• Donna M Clark, GNP
• John Richard Clark II, D.C.
• Ma.Belen S. Clark, M.D.

• Pediatrics Physician in Vista, CA
• Providers in Vista, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2018; 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.