Organization Active NPI

Tara M. Tomasso, M.D., L.L.C.

  • Family Medicine Physician
  • Woodbury Heights, NJ
National Provider Identifier
1659574713
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MA-71527 Issued in NJ
Legal business name
TARA M. TOMASSO, M.D., L.L.C.
Practice address
612 Glassboro Rd
Woodbury Heights, NJ 08097-1423
Phone
(856) 845-0323
Fax
(856) 845-4322
NPI assigned
Jun 7, 2007
Last updated
Mar 31, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Authorized official

Name
Dr. Tara M Tomasso, M.D.NPI 1225122401
Title
Owner
Phone
(856) 845-0323

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MA-71527 NJ Primary

Addresses

Primary practice location

612 Glassboro Rd
Woodbury Heights, NJ 08097-1423

Mailing address

612 Glassboro Rd
Woodbury Heights, NJ 08097-1423
Phone (856) 845-0323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070906000230 NJ Part B Supplier - Clinic/Group Practice 9032202155 Receives reassigned benefits from 1 practitioner
Practice locations: Woodbury Heights, NJ

National Provider Directory

National Provider Directory

Locations

612 Glassboro Rd
Woodbury Hts, NJ 08097
Phone (856) 845-0323

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617148800000",
    "number": "1659574713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 GLASSBORO RD",
            "city": "WOODBURY HEIGHTS",
            "state": "NJ",
            "postal_code": "080971423",
            "telephone_number": "856-845-0323",
            "fax_number": "856-845-4322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 GLASSBORO RD",
            "city": "WOODBURY HEIGHTS",
            "state": "NJ",
            "postal_code": "080971423",
            "telephone_number": "856-845-0323",
            "fax_number": "856-845-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARA M. TOMASSO, M.D., L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A",
        "authorized_official_last_name": "TOMASSO",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-845-0323",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA-71527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury Heights, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.