Individual provider Active NPI

Tara Pavelek, D.O.

  • Family Medicine Physician
  • Weatherford, TX
National Provider Identifier
1679990493
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P9438 Issued in TX
Practice address
713 E Anderson St
Weatherford, TX 76086-5705
Phone
(817) 599-1200
Fax
(817) 599-1269
NPI assigned
Mar 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X P9438 TX
Family Medicine Physician 207Q00000X P9438 TX Primary

Addresses

Primary practice location

713 E Anderson St
Weatherford, TX 76086-5705

Mailing address

2205 Ridgmar Blvd Apt 922
Fort Worth, TX 76116-2305
Phone (817) 599-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20140522000786 TX Practitioner - Family PracticePractitioner - Peripheral Vascular Disease 4082837901 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Peripheral Vascular Disease
Education
University of North Texas HSC, College of Osteopathic Med, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Texas Physician Services, PLLCGroup PAC ID 5890145783, 57 clinicians

Practice addresses (Care Compare)

600 N Union Ave
New Braunfels, TX 78130-4194
Phone (830) 606-9111

Hospital & facility affiliations

  • Trinity Hospice Hospice, San Antonio, TX, CCN 741591
  • Christus Santa Rosa Hospital-San Marcos Hospital, San Marcos, TX, CCN 450272

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Texas, PLLC Family Medicine CurrentSince Oct 1, 2022 Accepting new patients
Inpatient Medicine Physicians PA CurrentSince Apr 1, 2024 Accepting new patients
Cogent Healthcare of Texas, PA Family Medicine CurrentSince Oct 1, 2022 Accepting new patients
Lake Granbury Hospital-Based Professional Services CurrentSince Feb 12, 2024 Accepting new patients
Lone Star Extensivists PLLC CurrentSince Sep 1, 2024 Accepting new patients
South Texas Physician Services, PLLC CurrentSince Aug 5, 2024 Accepting new patients
Christus Santa Rosa Health Care Corporation Past Accepting new patients

Locations

1310 Paluxy Rd
Granbury, TX 76048
Phone (817) 573-2273

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

1275 Marvin Hancock Dr
Jasper, TX 75951
Phone (409) 384-1951

600 N Union Ave
New Braunfels, TX 78130
Phone (830) 606-9111

1619 E Common St
Ste 1201
New Braunfels, TX 78130
Phone (830) 620-0330

1672 Independence Dr
Ste 310
New Braunfels, TX 78132
Phone (830) 730-5025

1301 Wonder World Dr
San Marcos, TX 78666
Phone (512) 353-8979

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Interoperability endpoints

  • Direct secure messaging: tara.pavelek@hca7.eclinicaldirectplus.com

Organizations & group practices 7

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1395187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1679990493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 RIDGMAR BLVD APT 922",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761162305",
            "telephone_number": "817-599-1200",
            "fax_number": "817-598-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 E ANDERSON ST",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760865705",
            "telephone_number": "817-599-1200",
            "fax_number": "817-599-1269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVELEK",
        "first_name": "TARA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-19",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "P9438",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P9438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weatherford, TX

Sources for this page

Verify at the official NPI Registry.