Individual provider Active NPI

Taj Richardson

  • Physician Assistant
  • Tampa, FL
National Provider Identifier
1679343693
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
401 W Kennedy Blvd
Tampa, FL 33606-1450
Phone
(513) 375-3183
NPI assigned
Jan 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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 Primary

Addresses

Primary practice location

401 W Kennedy Blvd
Tampa, FL 33606-1450

Mailing address

401 W Kennedy Blvd
Tampa, FL 33606-1450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241111003305 DC Practitioner - Physician Assistant 4082148291 Reassigns benefits to 1 organization
I20241111003642 MD Practitioner - Physician Assistant 4082148291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anne Arundel Dermatology PAGroup PAC ID 6608761960, 126 clinicians

Practice addresses (Care Compare)

6410 Rockledge Dr
Suite 402
Bethesda, MD 20817-7807
Phone (301) 530-4800

7501 Greenway Ctr Dr
Suite 1000
Greenbelt, MD 20770-3513
Phone (301) 345-7375

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: tmrichardson@aadermaffiliates.emadirect.md

Organizations & group practices 1

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": "1704153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1679343693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W KENNEDY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336061450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W KENNEDY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336061450",
            "telephone_number": "513-375-3183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "TAJ",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-02",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.