Tara Nicole Andersen, PA-C
Individual provider Active NPI Physician Assistant · Osage Beach, MO
NPI 1699418160 · NPPES record last updated Oct 7, 2025
Key facts
- NPI
- 1699418160
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 2022006987 (MO)
- Practice address
- 54 Hospital Dr Ste 201
Osage Beach, MO 65065-3050 - Phone
- (573) 302-2764
- Fax
- (573) 302-2767
- NPI assigned
- Apr 13, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 17
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lake Regional Health System
Practice addresses (Care Compare)
54 Hospital Dr
Osage Beach, MO 65065-3050
Hospital & facility affiliations
- Lake Regional Health System
- University of Missouri Health Care
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.23 of 100
- Quality
- 58.17
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.92
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220801000762 | MO | Practitioner - Physician Assistant | 6002298528 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Regional Health System | Current |
Accepting new patients | |
| Lake Regional Health System | Past | Accepting new patients |
Locations
54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772
54 Hospital Dr
Ste 201
Osage Beach, MO 65065
Phone (573) 302-2764
Interoperability endpoints
- tandersen@mhccaremail.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2022006987 | MO | Yes |
Addresses
Primary practice location
54 Hospital Dr Ste 201
Osage Beach, MO 65065-3050
Mailing address
54 Hospital Dr Ste 201
Osage Beach, MO 65065-3050
Phone (573) 302-2764
Other providers in Osage Beach, MO
- Air Evac EMS, Inc.
- Align Chiropractic Clinic Loz LLC
- Whitney Allen
- American Physical Therapy, L.L.C.
- Melissa L Andersen
- Julia G Ansari
- Lane Armstrong
- Bonnie Jean Arntz
- Arrowhead Retirement Operations LLC
- Lindsey Ann Axthelm
All providers in Osage Beach, MO · Physician Assistant in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.