Dr Tara Kopp Bastek, MD | |
3000 New Bern Ave, Neonatology Dept., Raleigh, NC 27610-1231 | |
(919) 350-8545 | |
(919) 350-8146 |
Full Name | Dr Tara Kopp Bastek |
---|---|
Gender | Female |
Speciality | Pediatrics - Neonatal-perinatal Medicine |
Location | 3000 New Bern Ave, Raleigh, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1316956774 | NPI | - | NPPES |
891203C | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 9900162 (North Carolina) | Secondary |
2080N0001X | Pediatrics - Neonatal-perinatal Medicine | 9900162 (North Carolina) | Primary |
Entity Name | Wakemed Specialists Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1588227839 PECOS PAC ID: 2466788377 Enrollment ID: O20190731000815 |
Mailing Address | Practice Location Address |
---|---|
Dr Tara Kopp Bastek, MD 3024 New Bern Ave, Suite 300, Raleigh, NC 27610-1247 Ph: (919) 350-8228 | Dr Tara Kopp Bastek, MD 3000 New Bern Ave, Neonatology Dept., Raleigh, NC 27610-1231 Ph: (919) 350-8545 |
Sarah Owrey, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2800 Blue Ridge Rd, Suite 401, Raleigh, NC 27607 Phone: 919-781-7490 | |
Robert C Helms, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1921 Falls Valley Drive, Raleigh, NC 27615 Phone: 919-872-0250 Fax: 919-848-3137 | |
Dr. Christina Marie Flannelly, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 8300 Health Park Ste 213, Raleigh, NC 27615 Phone: 919-896-7066 Fax: 919-896-7067 | |
Jeff Lawrence Kantor, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 23 Sunnybrook Rd, Raleigh, NC 27610 Phone: 919-235-6435 | |
Dr. Delouis Terlonge Jr., MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3801 Computer Dr, Suite 200, Raleigh, NC 27609 Phone: 919-782-5273 Fax: 919-232-5551 | |
Larissa M. Saldana, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4551 New Bern Ave, Suite 160, Raleigh, NC 27610 Phone: 919-861-7793 Fax: 919-488-1458 | |
Dr. Bridget Mcnamara Degele, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607 Phone: 919-786-5001 Fax: 919-786-5051 |