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TARA PEMBERTON PA-C NPI 1275803462


NPI Information

NPI: 1275803462
Provider Name: TARA PEMBERTON, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Organization: JAMES W. BAKER, M.D., LLC

PECOS Registration: Yes

Address:
9495 SW LOCUST ST
SUITE A & E
PORTLAND, OR
ZIP 97223
Phone: (503) 505-5937
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Tara Pemberton, PA-C is a medical physician assistant in Portland, OR with 13 years of experience. Tara Pemberton, PA-C NPI is 1275803462. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

9495 SW LOCUST ST
SUITE A & E
PORTLAND, OR
ZIP 97223-683
Phone: (503) 505-5937
Fax: (503) 505-5922

The NPI 1275803462 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Destruction of 2-14 skin growths (HCPCS:17003)
  • Biopsy of single growth of skin and/or tissue (HCPCS:11100)
  • Destruction of skin growth (HCPCS:17000)

The enumeration date for this NPI number is 1/5/2012 and was last updated on 8/20/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363AM0700XPhysician AssistantMedicalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1G8908654MEDICARE PINWASHINGTON
2500643737MEDICAIDOREGON
3R164311MEDICARE PINOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.