NPIMap

Individual provider Active NPI

Tammy Tadom, MD

  • Addiction Medicine (Preventive Medicine) Physician
  • Lake Mary, FL
National Provider Identifier
1982627352
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X
License
ME78176 Issued in FL
Practice address
525 Technology Park Ste 109
Lake Mary, FL 32746-7107
Phone
(407) 647-2346
Fax
(407) 647-5431
NPI assigned
Jul 25, 2006
Last updated
Mar 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X ME78176 FL
Emergency Medicine Physician 207P00000X ME78176 FL
Addiction Medicine (Preventive Medicine) Physician 2083A0300X ME78176 FL Primary

Addresses

Primary practice location

525 Technology Park Ste 109
Lake Mary, FL 32746-7107

Mailing address

525 Technology Park
Ste 109
Lake Mary, FL 32746-7107
Phone (407) 647-2346

Other identifiers 3

IdentifierTypeStateIssuer
117797800MedicaidFL
P000120957OtherFLRAILROAD MCR
46926OtherFLBC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20040626000247 FL Practitioner - Internal MedicinePractitioner - EndocrinologyPractitioner - Addiction MedicinePractitioner - Emergency Medicine 5890771208 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Addiction Medicine
Education
University of Pittsburgh School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

900 Springwood Dr
Orlando, FL 32839-1318
Phone (407) 429-1065

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Michelle Riopedre LLC CurrentSince Dec 5, 2024 Accepting new patients
Central Florida Inpatient Medicine LLC CurrentSince Oct 1, 2015 Accepting new patients
Revive Transitional Care and in Home Primary Medicine, LLC CurrentSince Oct 7, 2024 Accepting new patients
Panamerican Behavioral Health Services of Florida LLC CurrentSince Jun 2, 2024 Accepting new patients
Nes of Florida Inc Emergency Medicine Past Accepting new patients
Inphynet Contracting Services LLC Emergency Medicine Past Accepting new patients
Palms of Pasadena Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Jessica J Wilson Chan D O PA PastSince Nov 3, 2019 Accepting new patients
Tarpon Springs Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Nes of Florida Inc Emergency Medicine Past Accepting new patients
Town & Country Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Pasco Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

525 Technology Park
Ste 109
Lake Mary, FL 32746
Phone 4076472346 ext. 111

917 Rinehart Rd
Ste 1051
Lake Mary, FL 32746
Phone (407) 562-9170

10967 Lake Underhill Rd
Ste 107
Orlando, FL 32825
Phone (321) 306-6014

7041 Grand National Dr
Ste 200
Orlando, FL 32819
Phone (407) 982-7718

Organizations & group practices 12

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 5

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1982627352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 TECHNOLOGY PARK",
            "address_2": "STE 109",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327467107",
            "telephone_number": "407-647-2346",
            "fax_number": "407-647-5431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 TECHNOLOGY PARK STE 109",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327467107",
            "telephone_number": "407-647-2346",
            "fax_number": "407-647-5431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADOM",
        "first_name": "TAMMY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "ME78176",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME78176",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "FL",
            "license": "ME78176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117797800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR",
            "identifier": "P000120957",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "46926",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.