Tara Deryavoush, DO - Medicare Internal Medicine in Mount Clemens, MI

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Tara Deryavoush, DO is a medicare enrolled "Internal Medicine" physician in Mount Clemens, Michigan. She went to Michigan State University College Of Osteopathic Medicine and graduated in 2014 and has 10 years of diverse experience with area of expertise as Internal Medicine. She is a member of the group practice Henry Ford Physician Partners and her current practice location is 133 S Main St, Mount Clemens, Michigan. You can reach out to her office (for appointments etc.) via phone at (586) 468-1600.

Tara Deryavoush is licensed to practice in Michigan (license number 5101020870) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1851718092.

Contact Information

Tara Deryavoush, DO
133 S Main St,
Mount Clemens, MI 48043-2308
(586) 468-1600
Not Available

Map and Direction




Physician's Profile

Full NameTara Deryavoush
GenderFemale
SpecialityInternal Medicine
Experience10 Years
Location133 S Main St, Mount Clemens, Michigan
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Tara Deryavoush attended and graduated from Michigan State University College Of Osteopathic Medicine in 2014
  NPI Data:
  • NPI Number: 1851718092
  • Provider Enumeration Date: 03/26/2014
  • Last Update Date: 07/21/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 3577783232
  • Enrollment ID: I20170522000933

Medical Identifiers

Medical identifiers for Tara Deryavoush such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1851718092NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208M00000XHospitalist 5101020870 (Michigan)Secondary
207R00000XInternal Medicine 5101020870 (Michigan)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Henry Ford Macomb HospitalClinton township, MIHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Henry Ford Physician Partners892148260560

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. Tara Deryavoush allows following entities to bill medicare on her behalf.
Entity NameGreat Lakes Medicine Plc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1740210517
PECOS PAC ID: 4880613637
Enrollment ID: O20051122000265
Entity NameAlliance Health Professionals Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1841615648
PECOS PAC ID: 7618199225
Enrollment ID: O20141117000290
Entity NameHenry Ford Physician Partners
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1427703602
PECOS PAC ID: 8921482605
Enrollment ID: O20220830000387

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. Tara Deryavoush 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 AddressPractice Location Address
Tara Deryavoush, DO
50505 Schoenherr Rd Ste 340,
Shelby Township, MI 48315-3140

Ph: (586) 731-8400		Tara Deryavoush, DO
133 S Main St,
Mount Clemens, MI 48043-2308

Ph: (586) 468-1600

Reviews and Comments


Internal Medicine Doctors in Mount Clemens, MI

Akhlema Paru Haidar, DO
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1000 Harrington St, Mount Clemens, MI 48043
Phone: 586-493-8142    Fax: 586-493-3250
Dr. Vasudevarao Mandava, M.D
Internal Medicine
Medicare: Medicare Enrolled
Practice Location: 18 Market St, Suite C, Mount Clemens, MI 48043
Phone: 586-783-2222    Fax: 586-783-6280
Japjit Kaur Serai, MD
Internal Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 1000 Harrington St, Mount Clemens, MI 48043
Phone: 586-493-3727    
Robert A Chang, MD
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 133 S Main St, Mount Clemens, MI 48043
Phone: 586-468-1600    Fax: 586-465-0329
Jayne Olivia Mitchell, D.O.
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1000 Harrington St, Mount Clemens, MI 48043
Phone: 586-493-8000    
Misha Kaur Chowdhary, MD
Internal Medicine
Medicare: Medicare Enrolled
Practice Location: 1000 Harrington St, Mount Clemens, MI 48043
Phone: 586-493-3727    
Travis Singh Sekhon, DO
Internal Medicine
Medicare: Medicare Enrolled
Practice Location: 1000 Harrington St, Mount Clemens, MI 48043
Phone: 586-493-3727    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.