NPIMap

Individual provider Active NPI

Tara Alexandra McCannel, MD

  • Ophthalmology Physician
  • Los Angeles, CA
National Provider Identifier
1790707842
Registry record updated May 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A87675 Issued in CA
Practice address
100 Stein Plaza
RM 1-340
Los Angeles, CA 90095-7065
Phone
(310) 825-5000
NPI assigned
Jul 24, 2006
Last updated
May 7, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A87675 CA Primary

Addresses

Primary practice location

100 Stein Plaza
RM 1-340
Los Angeles, CA 90095-7065

Mailing address

5767 W Century Blvd
Suite 400
Los Angeles, CA 90045-5631
Phone (310) 825-5000

Other identifiers 1

IdentifierTypeStateIssuer
00A876750MedicaidCA

Other names 1

  • Tara A Young Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101202000154 CA Practitioner - Ophthalmology 0648167601 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

622 W Duarte Rd
Suite 101
Arcadia, CA 91007-7606
Phone (323) 442-7122

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.31 of 100Reported as group
Quality
78.96
Promoting interoperability
100
Improvement activities
40
Cost
71.72

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Jules Stein Eye Institute Medical Group Ophthalmology CurrentSince Sep 1, 2004 Accepting new patients
Jules Stein Eye Institute Medical Group CurrentSince Sep 1, 2004 Accepting new patients
UCLA Medical Group Ophthalmology Past Accepting new patients
Massachusetts Eye and Ear Infirmary Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
The Regents of the University of California Past Accepting new patients

Locations

622 W Duarte Rd
Ste 101
Arcadia, CA 91007
Phone (310) 206-1166

100 Stein Plz
Rm 1340
Los Angeles, CA 90095
Phone (310) 206-1166

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

Interoperability endpoints

  • Direct secure messaging: tmccannel43169@direct.uclahealth.org

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367884800000",
    "number": "1790707842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD",
            "address_2": "SUITE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-825-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 STEIN PLAZA",
            "address_2": "RM 1-340",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900957065",
            "telephone_number": "310-825-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCANNEL",
        "first_name": "TARA",
        "middle_name": "ALEXANDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2013-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A87675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A876750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "YOUNG",
            "middle_name": "A",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.