Active NPI
Tara Mahon, APRN
- Primary Care Nurse Practitioner
- Farmington, CT
National Provider Identifier
1710520739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 008488
- Practice address
- 263 Farmington Ave
Farmington, CT 06030-0001 - Phone
- (860) 679-2000
- NPI assigned
- Oct 22, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 8488 | CT | |
| Primary Care Nurse Practitioner | 363LP2300X | 008488 | CT | Primary |
Addresses
Primary practice location
263 Farmington Ave
Farmington, CT 06030-0001
Mailing address
5 Riverbend LN
Collinsville, CT 06019-3418
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- University of Connecticut School of Medicine, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-3692
Hospital & facility affiliations
- John Dempsey Hospital of the University of Connect
- Hartford Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008488 | CT | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Connecticut Health Center | Current | Accepting new patients | |
| University of Connecticut Health Center | Current | Accepting new patients | |
| University of Connecticut Health Center | Past | Accepting new patients |
Locations
263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477
Interoperability endpoints
- tmahon8489@direct.med.uchc.edu
Organizations & group practices 3
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.
-
- General Practice Physician
- Farmington, CT
- NPI 1720083769
-
- Durable Medical Equipment & Medical Supplies
- Farmington, CT
- NPI 1104809375
-
- Clinical Medical Laboratory
- Farmington, CT
- NPI 1427031293
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Hartford, CT
- NPI 1770696643
-
- General Acute Care Hospital
- Hartford, CT
- NPI 1902834880
-
- Psychiatric Hospital Unit
- Middletown, CT
- NPI 1154263713
-
- General Acute Care Hospital
- Farmington, CT
- NPI 1669466561
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574640000000",
"number": "1710520739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 RIVERBEND LN",
"city": "COLLINSVILLE",
"state": "CT",
"postal_code": "060193418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "263 FARMINGTON AVE",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "060300001",
"telephone_number": "860-679-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHON",
"first_name": "TARA",
"credential": "APRN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-22",
"last_updated": "2019-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CT",
"license": "8488",
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "CT",
"license": "008488",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Farmington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; 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.