Active NPI
Shelly Tat, DO
- Family Medicine Physician
- Highland Heights, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 05196
- Practice address
- 2626 Alexandria Pike
Highland Heights, KY 41076-1530 - Phone
- (859) 781-4111
- Fax
- (859) 441-5214
- NPI assigned
- Jun 18, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuromusculoskeletal Medicine & OMM Physician | 204D00000X | 05196 | KY | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 05196 | KY | Primary |
Addresses
Primary practice location
2626 Alexandria Pike
Highland Heights, KY 41076-1530
Mailing address
2626 Alexandria Pike
Highland Heights, KY 41076-1530
Phone (859) 781-4111
Other practice location 1
413 S Loop Rd
Edgewood, KY 41017-5446
Phone (859) 301-3800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2626 Alexandria Pike
Highland Heights, KY 41076-1530
Phone (859) 757-0434
580 Buttermilk Pike
Crescent Springs, KY 41017-1635
Phone (859) 341-6654
7567 Central Parke Blvd
A
Mason, OH 45040-6852
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Group, Inc. | Current | Accepting new patients | |
| Summit Medical Group, Inc. | Family Medicine | Current | Accepting new patients |
| Summit Medical Group, Inc | Family Medicine | Current | Accepting new patients |
Locations
1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700
2626 Alexandria Pike
Highland Heights, KY 41076
Phone (859) 757-0434
1400 Grand Ave
Newport, KY 41071
Phone (859) 905-3070
300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217
Interoperability endpoints
- stat404646@direct-prd.stelizabeth.com
Organizations & group practices 5
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.
-
dba St. Elizabeth Physicians
- Family Medicine Physician
- Erlanger, KY
- NPI 1750343216
-
dba NovaCare Rehabilitation
- Physical Therapy Clinic/Center
- Crescent Springs, KY
- NPI 1790780617
-
- Physical Therapist
- Mason, OH
- NPI 1326126061
-
dba St. Elizabeth Physicians
- Foot & Ankle Surgery Podiatrist
- Crestview Hills, KY
- NPI 1043188378
-
dba St. Elizabeth Physicians Urgent Care
- Urgent Care Clinic/Center
- Highland Heights, KY
- NPI 1881026169
Family Medicine
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St Elizabeth Florence
- General Acute Care Hospital
- Florence, KY
- NPI 1154365062
-
- General Acute Care Hospital
- Edgewood, KY
- NPI 1467492421
-
dba St Elizabeth Ft. Thomas
- General Acute Care Hospital
- Fort Thomas, KY
- NPI 1740221795
-
dba St. Elizabeth Home Care
- Home Health Agency
- Florence, KY
- NPI 1316136534
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708646400000",
"number": "1699335067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2626 ALEXANDRIA PIKE",
"city": "HIGHLAND HEIGHTS",
"state": "KY",
"postal_code": "410761530",
"telephone_number": "859-781-4111",
"fax_number": "859-441-5214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2626 ALEXANDRIA PIKE",
"city": "HIGHLAND HEIGHTS",
"state": "KY",
"postal_code": "410761530",
"telephone_number": "859-781-4111",
"fax_number": "859-441-5214"
}
],
"practiceLocations": [
{
"address_1": "413 S Loop Rd",
"address_purpose": "LOCATION",
"city": "Edgewood",
"state": "KY",
"postal_code": "410175446",
"country_code": "US",
"telephone_number": "859-301-3800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TAT",
"first_name": "SHELLY",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-18",
"last_updated": "2024-02-23",
"certification_date": "2024-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "204D00000X",
"taxonomy_group": "",
"desc": "Neuromusculoskeletal Medicine & OMM",
"state": "KY",
"license": "05196",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KY",
"license": "05196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Highland Heights, KY
- Summit Medical Group, Inc (St. Elizabeth Physicians)
- Summit Medical Group, Inc. (St. Elizabeth Physicians Urgent Care)
- Synergy Chiropractic, Inc
- Tapp Into Chiropractic, PLLC
- Heather Noelle Tapp, DC
- Rose A Tempel, NP
- Mary Elizabeth Thatcher, P.T.
- Sarah Vanover, APRN
- Rachele Elizabeth Vogelpohl, PHD, ATC
- Jarrod R Walerstein, DO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.