NPIMap

Individual provider Active NPI

Tanya Deanne Campus, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Lawrence, MA
National Provider Identifier
1932175049
Registry record updated Oct 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
238352 Issued in MA
Practice address
150 Park St
Lawrence, MA 01841-2517
Phone
(978) 685-1770
Fax
(978) 682-5787
NPI assigned
Feb 28, 2006
Last updated
Oct 9, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 238352 MA Primary

Addresses

Primary practice location

150 Park St
Lawrence, MA 01841-2517

Mailing address

150 Park St
Lawrence, MA 01841-2517
Phone (978) 685-1770

Other identifiers 3

IdentifierTypeStateIssuer
290810099MedicaidME
003968OtherMEANTHEM
0967149005OtherMECIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20180730000250 MA Practitioner - Family PracticePractitioner - Geriatric Medicine 1951371228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

150 Park St
Lawrence, MA 01841-2517
Phone (978) 685-1770

34 Haverhill St
Lawrence, MA 01841-2884
Phone (978) 686-0090

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Lawrence Family Health Center Inc CurrentSince Jul 16, 2018 Accepting new patients
Greater Lawrence Family Health Center, Inc. CurrentSince Jul 16, 2018 Accepting new patients
Mi Nursing-Restorative Center Inc Past Accepting new patients
Howard R Margolskee,MD PA Past Accepting new patients

Locations

150 Park St
Lawrence, MA 01841
Phone (978) 685-1770

34 Haverhill St
Lawrence, MA 01841

Interoperability endpoints

  • Direct secure messaging: tanya.campus.1@23857.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1932175049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 PARK ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412517",
            "telephone_number": "978-685-1770",
            "fax_number": "978-682-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 PARK ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412517",
            "telephone_number": "978-685-1770",
            "fax_number": "978-682-5787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPUS",
        "first_name": "TANYA",
        "middle_name": "DEANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MA",
            "license": "238352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290810099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "003968",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0967149005",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

Verify at the official NPI Registry.