Individual provider Active NPI

Brandon K Tari

  • Surgery Physician
  • Brockton, MA
National Provider Identifier
1992826408
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
250234 Issued in MA
Practice address
680 Centre St
Brockton, MA 02302-3308
Phone
(508) 941-7000
NPI assigned
Apr 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 250234 MA Primary

Addresses

Primary practice location

680 Centre St
Brockton, MA 02302-3308

Mailing address

825 Washington St
Suite 220
Norwood, MA 02062-3441
Phone (781) 762-2600

Other practice location 1

825 Washington St
Suite 220
Norwood, MA 02062-3441
Phone (781) 762-2600

Other practice location 2

110 Liberty St
Brockton, MA 02301-5674
Phone (508) 894-0400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20121128000615 MA Practitioner - General Surgery 0345492278 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
New York Medical College, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Signature Healthcare Medical Group IncGroup PAC ID 7719876267, 250 clinicians

Practice addresses (Care Compare)

110 Liberty St
Brockton, MA 02301-5521
Phone (508) 894-0400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)15
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Sep 30, 2012 Accepting new patients
Steward Medical Group, Inc CurrentSince Sep 30, 2012 Accepting new patients
Signature Healthcare Medical Group Inc Surgery CurrentSince Aug 1, 2024 Accepting new patients
Brockton Hospital, Inc. Past Accepting new patients

Locations

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

110 Liberty St
Brockton, MA 02301

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

800 Washington St
Norwood, MA 02062
Phone (781) 278-6264

825 Washington St
Ste 220
Norwood, MA 02062
Phone (781) 762-0471

Interoperability endpoints

  • Direct secure messaging: brandon.tari@direct.signature.masshiway.net

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 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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1992826408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 WASHINGTON ST",
            "address_2": "SUITE 220",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020623441",
            "telephone_number": "781-762-2600",
            "fax_number": "781-769-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 CENTRE ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023023308",
            "telephone_number": "508-941-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Washington St",
            "address_2": "Suite 220",
            "address_purpose": "LOCATION",
            "city": "Norwood",
            "state": "MA",
            "postal_code": "020623441",
            "country_code": "US",
            "telephone_number": "781-762-2600",
            "fax_number": "781-769-3723",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 Liberty St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023015674",
            "country_code": "US",
            "telephone_number": "508-894-0400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TARI",
        "first_name": "BRANDON",
        "middle_name": "K",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "250234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.