Active NPI
Tara Jane Demoret, OTR/L
- Occupational Therapist
- Omaha, NE
National Provider Identifier
1982324950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2612
- Practice address
- 4330 S 144TH St
Omaha, NE 68137-1051 - Phone
- (402) 614-4000
- NPI assigned
- Aug 30, 2022
- Last updated
- Aug 30, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2612 | NE | Primary |
Addresses
Primary practice location
4330 S 144TH St
Omaha, NE 68137-1051
Mailing address
4330 S 144TH St
Omaha, NE 68137-1051
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5114 N 137TH St
Omaha, NE 68164-6191
Phone (402) 819-7956
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2612 | NE | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Diversified Mobile PT LLC | Occupational Therapist | Current | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661817600000",
"number": "1982324950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4330 S 144TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681371051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4330 S 144TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681371051",
"telephone_number": "402-614-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMORET",
"first_name": "TARA",
"middle_name": "JANE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-30",
"last_updated": "2022-08-30",
"certification_date": "2022-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NE",
"license": "2612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.