Individual provider Active NPI

Cory Taraska

  • Physician Assistant
  • Palmetto, FL
National Provider Identifier
1861251605
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9118487 Issued in FL
Practice address
430 8TH Ave W
Palmetto, FL 34221-5120
Phone
(941) 531-2800
NPI assigned
Mar 14, 2024
Last updated
Apr 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9118487 FL Primary
Physician Assistant 363A00000X NU

Addresses

Primary practice location

430 8TH Ave W
Palmetto, FL 34221-5120

Mailing address

430 8TH Ave W
Palmetto, FL 34221-5120

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250130004233 FL Practitioner - Physician Assistant 3375072630 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Health First Privia Medical GroupGroup PAC ID 3173965993, 247 clinicians
Aldrich Cardiovascular InstituteGroup PAC ID 5597796664, 11 clinicians

Practice addresses (Care Compare)

140 6TH Ave
Indialantic, FL 32903-3204
Phone (321) 312-3501

6310 Health Park Way
Suite 330
Lakewood Ranch, FL 34202-5177
Phone (941) 359-8900

7250 Beneva Rd
Sarasota, FL 34238-2806
Phone (770) 312-5226

989 Sebastian Blvd
Unit 3
Sebastian, FL 32958-4879
Phone (727) 617-1777

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9118487FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aldrich Cardiovascular Institute CurrentSince Jan 2, 2026 Accepting new patients
Venture Medical of Florida LLC Physician Assistant CurrentSince Mar 17, 2024 Accepting new patients

Locations

6310 Health Park Way
Ste 330
Lakewood Ranch, FL 34202
Phone (941) 359-8900

430 8th Ave W
Palmetto, FL 34221
Phone (941) 531-2800

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: cory.taraska.1@8042.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/EADACD

Organizations & group practices 3

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": "1710374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1861251605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 8TH AVE W",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342215120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 8TH AVE W",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342215120",
            "telephone_number": "941-531-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARASKA",
        "first_name": "CORY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9118487",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmetto, FL

Sources for this page

Verify at the official NPI Registry.