Individual provider Active NPI

Tanya S Harris, MD

  • Physical Medicine & Rehabilitation Physician
  • San Angelo, TX
National Provider Identifier
1861447575
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
S8570 Issued in TX
Practice address
6102 Appaloosa Trail
San Angelo, TX 76901
Phone
(325) 895-9945
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 0101239550 VA
Physical Medicine & Rehabilitation Physician 208100000X S8570 TX Primary

Addresses

Primary practice location

6102 Appaloosa Trail
San Angelo, TX 76901

Mailing address

PO Box 62665
San Angelo, TX 76906-2665
Phone (325) 895-9945

Other practice location 1

400 Gresham Dr
Suite 712
Norfolk, VA 23507-1901
Phone (757) 622-8181

Other identifiers 1

IdentifierTypeStateIssuer
S8570OtherTXMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210414002267 TX Practitioner - Physical Medicine and Rehabilitation 3375546328
I20240730003111 WA Practitioner - Physical Medicine and Rehabilitation 3375546328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Temple University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 697-1962

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

  • Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079
  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
  • Multicare Good Samaritan Hospital Inpatient rehabilitation facility, Puyallup, WA, CCN 50T079

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101239550VAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Physical Medicine & Rehabilitation CurrentSince Jun 25, 2024 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Jun 25, 2024 Accepting new patients
Tidewater Comprehensive Rehabilitation, PLLC Physical Medicine & Rehabilitation CurrentSince Jan 1, 1990 Accepting new patients
Multicare Health System Past Accepting new patients

Locations

400 Gresham Dr
Ste 712
Norfolk, VA 23507
Phone (757) 622-8181

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

Organizations & group practices 5

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 3

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1861447575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62665",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769062665",
            "telephone_number": "325-895-9945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6102 APPALOOSA TRAIL",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "76901",
            "telephone_number": "325-895-9945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Gresham Dr",
            "address_2": "SUITE 712",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071901",
            "country_code": "US",
            "telephone_number": "757-622-8181",
            "fax_number": "757-410-8963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "TANYA",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0101239550",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "S8570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "S8570",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.