Individual provider Active NPI

Tara Nierenberg, M.S.W.

  • Clinical Social Worker
  • Corvallis, OR
National Provider Identifier
1730414418
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L6484 Issued in OR
Practice address
636 SW 2ND St
Corvallis, OR 97333-4442
Phone
(541) 250-0617
NPI assigned
Oct 13, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L6484 OR Primary

Addresses

Primary practice location

636 SW 2ND St
Corvallis, OR 97333-4442

Mailing address

636 SW 2ND St
Corvallis, OR 97333-4442
Phone (541) 250-0617

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160215002051 OR Practitioner - Clinical Social Worker 0042514887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

636 SW 2ND St
Corvallis, OR 97333-4442
Phone (541) 250-0617

Merit-based Incentive Payment System (MIPS)

Final score
91.14 of 100Reported as group
Quality
85.78
Promoting interoperability
100
Improvement activities
40
Cost
78.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L6484ORMDClinical Social Worker

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1255392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1730414418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 SW 2ND ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973334442",
            "telephone_number": "541-250-0617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 SW 2ND ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973334442",
            "telephone_number": "541-250-0617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIERENBERG",
        "first_name": "TARA",
        "credential": "M.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-13",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L6484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.