Individual provider Active NPI

Tara Brewer, P.A.

  • Medical Physician Assistant
  • East Aurora, NY
National Provider Identifier
1881604098
Registry record updated Mar 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
008052-1 Issued in NY
Practice address
112 Olean St
Suite 220
East Aurora, NY 14052-2540
Phone
(716) 805-1072
Fax
(716) 805-1073
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C0002406 MD
Medical Physician Assistant 363AM0700X 008052-1 NY Primary

Addresses

Primary practice location

112 Olean St
Suite 220
East Aurora, NY 14052-2540

Mailing address

112 Olean St
Suite 220
East Aurora, NY 14052-2540
Phone (716) 805-1072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20070912000784 NY Practitioner - Physician Assistant 9133180771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Aurora Family Practice,LLPGroup PAC ID 5496733404, 9 clinicians

Practice addresses (Care Compare)

112 Olean St
East Aurora, NY 14052-2540
Phone (716) 805-1072

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008052NYMDOccupational Therapy Assistant
C0002406MDMDMedical Physician Assistant
008052-1NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical Associates,LLC Past Accepting new patients

Organizations & group practices 2

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 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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299801600000",
    "number": "1881604098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 OLEAN ST",
            "address_2": "SUITE 220",
            "city": "EAST AURORA",
            "state": "NY",
            "postal_code": "140522540",
            "telephone_number": "716-805-1072",
            "fax_number": "716-805-1073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 OLEAN ST",
            "address_2": "SUITE 220",
            "city": "EAST AURORA",
            "state": "NY",
            "postal_code": "140522540",
            "telephone_number": "716-805-1072",
            "fax_number": "716-805-1073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "TARA",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2011-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0002406",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "008052-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Aurora, NY

Sources for this page

Verify at the official NPI Registry.