Individual provider Active NPI

Tamara Ellen Merritt, DO

  • General Practice Physician
  • Leavenworth, WA
National Provider Identifier
1821022492
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
OP00002089 Issued in WA
Practice address
817 Commercial St
Leavenworth, WA 98826-1316
Phone
(509) 548-5815
Fax
(509) 548-2510
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP00002089 WA
General Practice Physician 208D00000X OP00002089 WA Primary

Addresses

Primary practice location

817 Commercial St
Leavenworth, WA 98826-1316

Mailing address

817 Commercial St
Leavenworth, WA 98826-1316
Phone (509) 548-3430

Other practice location 1

525 West Jay
Brewster, WA 98812-9701
Phone (509) 689-3455

Other identifiers 3

IdentifierTypeStateIssuer
316507OtherWADEPARTMENT OF LABOR AND INDUSTRIES
8464240MedicaidWA
452251OtherWADEPARTMENT OF LABOR AND INDUSTRIES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20070116000568 WA Practitioner - Family Practice 6406857549 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chelan County Public Hospital District No. 1Group PAC ID 3971491234, shared by 3 NPIs, 23 clinicians

Practice addresses (Care Compare)

817 Commercial St
Leavenworth, WA 98826-1316
Phone (509) 548-3420

Hospital & facility affiliations

  • Central Washington Health Services Home health agency, Wenatchee, WA, CCN 507029
  • Advanced Home Health NW of Wenatchee Home health agency, Wenatchee, WA, CCN 507113
  • Central Washington Hospital Homecare Services Hospice, Wenatchee, WA, CCN 501516
  • Cascade Medical Center Hospital, Leavenworth, WA, CCN 501313
  • Confluence Health Hospital Hospital, Wenatchee, WA, CCN 500016
  • Cascade Medical Center Nursing home, CCN 50Z313

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OP00002089WAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chelan County Public Hospital District No. 1 CurrentSince Sep 1, 2013 Accepting new patients
Chelan County Public Hospital District No. 1 Current Accepting new patients
Chelan County Public Hospital District No. 1 Current Accepting new patients
Family Health Centers Past Accepting new patients

Locations

817 Commercial St
Leavenworth, WA 98826
Phone (509) 548-3420

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1821022492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 COMMERCIAL ST",
            "city": "LEAVENWORTH",
            "state": "WA",
            "postal_code": "988261316",
            "telephone_number": "509-548-3430",
            "fax_number": "509-548-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 COMMERCIAL ST",
            "city": "LEAVENWORTH",
            "state": "WA",
            "postal_code": "988261316",
            "telephone_number": "509-548-5815",
            "fax_number": "509-548-2510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 WEST JAY",
            "address_purpose": "LOCATION",
            "city": "BREWSTER",
            "state": "WA",
            "postal_code": "988129701",
            "country_code": "US",
            "telephone_number": "509-689-3455",
            "fax_number": "509-689-2104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERRITT",
        "first_name": "TAMARA",
        "middle_name": "ELLEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00002089",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WA",
            "license": "OP00002089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR AND INDUSTRIES",
            "identifier": "316507",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8464240",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR AND INDUSTRIES",
            "identifier": "452251",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leavenworth, WA

Sources for this page

Verify at the official NPI Registry.