Tara L Gustilo, MD MPH

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

35084663 Issued in OH

Practice address

434 4TH St Ste 305
Newport, TN 37821-3735

Phone

(423) 415-3330

Fax

(423) 613-1173

NPI assigned

Jun 23, 2006

Last updated

Dec 5, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tara L Gustilo-Ashby Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Obstetrics/Gynecology

Education

Mayo Medical School, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Champion Physical Therapy LLC HallsGroup PAC ID 1355416306, shared by 4 NPIs, 277 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tennova Healthcare - Newport Medical Center Hospital, Newport, TN, CCN 440153

Merit-based Incentive Payment System (MIPS)

Final score

88.07 of 100Reported as apm

Quality

73.89

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/4694/brand/1/csg/1/fhir/r4
• Direct secure messaging: tara.gustilo.1@4694.direct.athenahealth.com
• Direct secure messaging: tara.gustilo.2@4694.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Knoxville Hma Physician Management, LLC

  • Pulmonary Disease Physician
  • Knoxville, TN
  • NPI 1629356969

  Obstetrics & Gynecology

  NPD

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

• Cocke County Hma, LLC

  dba Tennova Healthcare-Newport Medical Center

  • General Acute Care Hospital
  • Newport, TN
  • NPI 1972576247
  Care Compare affiliation

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1710913900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 4TH ST STE 305",
            "city": "NEWPORT",
            "state": "TN",
            "postal_code": "378213735",
            "telephone_number": "423-415-3330",
            "fax_number": "423-613-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 4TH ST STE 305",
            "city": "NEWPORT",
            "state": "TN",
            "postal_code": "378213735",
            "telephone_number": "423-415-3330",
            "fax_number": "423-613-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTILO",
        "first_name": "TARA",
        "middle_name": "L",
        "credential": "MD MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "35084663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2557782",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tara.gustilo.1@4694.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "434 4th St Ste 305",
            "city": "Newport",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378213735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "GUSTILO-ASHBY",
            "middle_name": "L",
            "credential": "MD MPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Darla Anne Greene, LCSW
• Leah Renee Gregg, R.N.
• Leanne Weems Gregg, PT
• Mandy Proffitt Gregg, R
• Charlie Grooms, FNP-BC
• Stephanie Gwynn, LPC-MHSP
• Ashley Nicole Haley, MSW
• Kristi Renee Hansel, BSW
• Katlyn Hanson, RN
• Harmony Oaks Recovery Center, LLC

• Obstetrics & Gynecology Physician in Newport, TN
• Providers in Newport, TN by specialty
• Obstetrics & Gynecology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.

Verify at the official NPI Registry.