Individual provider Active NPI

Tara Lair, PA-C

  • Physician Assistant
  • Cincinnati, OH
National Provider Identifier
1609963990
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50004547RX Issued in OH
Practice address
7794 5 Mile Rd Ste 240
Cincinnati, OH 45230-2372
Phone
(513) 231-1575
Fax
(855) 818-3918
NPI assigned
Oct 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50004547RX OH Primary

Addresses

Primary practice location

7794 5 Mile Rd Ste 240
Cincinnati, OH 45230-2372

Mailing address

7794 Five Mile Road
Suite 240
Cincinnati, OH 45230
Phone (513) 231-1575

Other identifiers 2

IdentifierTypeStateIssuer
0160056MedicaidOH
7100220510MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170710001346 OH Practitioner - Physician Assistant 8325103377 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Kentucky College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatologists of Southwestern Ohio, LLCGroup PAC ID 7113973041, 116 clinicians

Practice addresses (Care Compare)

5300 Far Hills Ave
Dayton, OH 45429-2381
Phone (937) 433-7536

6480 Harrison Ave
Suite 303
Cincinnati, OH 45247-7961
Phone (513) 541-5050

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50004547RXOHMDPhysician Assistant

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": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1609963990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7794 FIVE MILE ROAD",
            "address_2": "SUITE 240",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45230",
            "telephone_number": "513-231-1575",
            "fax_number": "855-818-3918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7794 5 MILE RD STE 240",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452302372",
            "telephone_number": "513-231-1575",
            "fax_number": "855-818-3918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIR",
        "first_name": "TARA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50004547RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0160056",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100220510",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.