Dr Tara Powers Brantley, MD, DMD in San Francisco, CA

Dr Tara Powers Brantley, MD, DMD is a medicare enrolled "Dentist - Oral And Maxillofacial Surgery" provider in San Francisco, California. Her current practice location is 1001 Potrero Avenue, Bldg. 5, Fl. 1. #1n, San Francisco, California. You can reach out to her office (for appointments etc.) via phone at (628) 206-8104.

Dr Tara Powers Brantley is licensed to practice in California (license number A182566) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1932685740.

Contact Information

	Dr Tara Powers Brantley, MD, DMD
	1001 Potrero Avenue, Bldg. 5, Fl. 1. #1n, San Francisco, CA 94110-3518
	(628) 206-8104
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Tara Powers Brantley
Gender	Female
Speciality	Dentist - Oral And Maxillofacial Surgery
Location	1001 Potrero Avenue, San Francisco, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1932685740
Provider Enumeration Date: 07/15/2018
Last Update Date: 08/09/2024

Medicare PECOS Information:

PECOS PAC ID: 2567868334
Enrollment ID: I20230414002100

Medical Identifiers

Medical identifiers for Dr Tara Powers Brantley such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1932685740	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	00203363 (Colorado)	Secondary
1223S0112X	Dentist - Oral And Maxillofacial Surgery	D11766 (Oregon)	Secondary
208600000X	Surgery	A182566 (California)	Secondary
1223S0112X	Dentist - Oral And Maxillofacial Surgery	A182566 (California)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Tara Powers Brantley allows following entities to bill medicare on her behalf.

Entity Name	Legacy Clinics Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1902827272 PECOS PAC ID: 0244144004 Enrollment ID: O20031117000089

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Tara Powers Brantley is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Tara Powers Brantley, MD, DMD Po Box 743749, San Francisco, CA 90074-3749 Ph: () -	Dr Tara Powers Brantley, MD, DMD 1001 Potrero Avenue, Bldg. 5, Fl. 1. #1n, San Francisco, CA 94110-3518 Ph: (628) 206-8104

Reviews and Comments

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Dr Tara Powers Brantley, MD, DMD - Medicare Dentist in San Francisco, CA