Active NPI
Joao O Tavares, MD
- Pediatric Orthopaedic Surgery Physician
- Erie, PA
National Provider Identifier
1750425351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Orthopaedic Surgery Physician
- License
- MD-034945-L
- Practice address
- 1645 West 8TH Street
Shriners Hospitals for Children Erie
Erie, PA 16505-5097 - Phone
- (814) 875-8728
- Fax
- (814) 875-8796
- NPI assigned
- Feb 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Orthopaedic Surgery Physician | 207XP3100X | MD-034945-L | PA | Primary |
Addresses
Primary practice location
1645 West 8TH Street
Shriners Hospitals for Children Erie
Erie, PA 16505-5097
Mailing address
PO Box 8500
Shriners Hospitals for Children Lockbox #7642
Philadelphia, PA 19178-7642
Phone (813) 281-8478
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0662516-02 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD-034945-L | PA | MD | Pediatric Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348704000000",
"number": "1750425351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8500",
"address_2": "SHRINERS HOSPITALS FOR CHILDREN LOCKBOX #7642",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191787642",
"telephone_number": "813-281-8478",
"fax_number": "813-281-8113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1645 WEST 8TH STREET",
"address_2": "SHRINERS HOSPITALS FOR CHILDREN ERIE",
"city": "ERIE",
"state": "PA",
"postal_code": "165055097",
"telephone_number": "814-875-8728",
"fax_number": "814-875-8796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAVARES",
"first_name": "JOAO",
"middle_name": "O",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-16",
"last_updated": "2012-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "207XP3100X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
"state": "PA",
"license": "MD-034945-L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0662516-02",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.