Individual provider Active NPI

Tucker Ellen Doiron

  • Obstetrics & Gynecology Physician
  • Little Rock, AR
National Provider Identifier
1649731944
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2023011830 Issued in MO
Practice address
4301 W Markham St # 518
Little Rock, AR 72205-7101
Phone
(501) 526-7569
NPI assigned
Mar 28, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X 2023011830 MO Primary

Addresses

Primary practice location

4301 W Markham St # 518
Little Rock, AR 72205-7101

Mailing address

1028 Oak Harbor Dr
Morgan City, LA 70380-8041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20230525001298 MO Practitioner - Obstetrics/Gynecology 9133454614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Louisiana State University School of Medicine in New Orleans, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

215 N Marengo Ave
Suite 201
Pasadena, CA 91101-1532

PO Box
Suite 50938
Los Angeles, CA 90074

Merit-based Incentive Payment System (MIPS)

Final score
84.94 of 100Reported as group
Quality
68.52
Promoting interoperability
100
Improvement activities
40
Cost
72.22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023011830MOMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group Multi-Specialty CurrentSince Jun 1, 2023 Accepting new patients
SSM Health Care Group Multi-Specialty CurrentSince Jun 1, 2023 Accepting new patients
SSM Health Care St. Louis Past Accepting new patients

Locations

1031 Bellevue Ave
Ste 400
Saint Louis, MO 63117

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

Interoperability endpoints

  • Direct secure messaging: tdoiron454307@direct-ehr-ssmhc.com

Organizations & group practices 3

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": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1649731944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 OAK HARBOR DR",
            "city": "MORGAN CITY",
            "state": "LA",
            "postal_code": "703808041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 518",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-526-7569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOIRON",
        "first_name": "TUCKER",
        "middle_name": "ELLEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2023011830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.