Individual provider Active NPI

Tara Breanne Spector, M.D.

  • Internal Medicine Physician
  • Ann Arbor, MI
National Provider Identifier
1689800815
Registry record updated Mar 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301106714 Issued in MI
Practice address
1500 E Medical Center Drive
3Rd Floor Taubman Center Recp B
Ann Arbor, MI 48109-5352
Phone
(734) 936-5582
NPI assigned
Jun 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD60265227 WA
Internal Medicine Physician 207R00000X 4301106714 MI Primary

Addresses

Primary practice location

1500 E Medical Center Drive
3Rd Floor Taubman Center Recp B
Ann Arbor, MI 48109-5352

Mailing address

3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047

Other identifiers 2

IdentifierTypeStateIssuer
1689800815MedicaidWA
0293963OtherWAL&I

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20160810001265 NC Practitioner - HospitalistPractitioner - Internal Medicine 1850557158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
University of Pittsburgh School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke University Health System, IncGroup PAC ID 2567372345, 1,083 clinicians

Practice addresses (Care Compare)

3643 N Roxboro Rd
Durham, NC 27704-2702
Phone (919) 470-8490

Hospital & facility affiliations

  • Duke University Hospital Hospital, Durham, NC, CCN 340030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301106714MIMDInternal Medicine Physician
MD60265227WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Health System, Inc. Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients
Duke University Health System, Inc. CurrentSince Jul 1, 2016 Accepting new patients

Locations

5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

3400 Wake Forest Rd
Raleigh, NC 27609
Phone (919) 954-3000

Interoperability endpoints

  • Direct secure messaging: tspector6600@direct.medicine.duke.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1689800815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DRIVE",
            "address_2": "3RD FLOOR TAUBMAN CENTER RECP B",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095352",
            "telephone_number": "734-936-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPECTOR",
        "first_name": "TARA",
        "middle_name": "BREANNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-02",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60265227",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301106714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689800815",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0293963",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.