Tara L Gustilo, MD MPH is a medicare enrolled "Obstetrics & Gynecology" physician in Newport, Tennessee. She went to Mayo Medical School and graduated in 1994 and has 30 years of diverse experience with area of expertise as Obstetrics/gynecology. She is a member of the group practice Champion Physical Therapy Llc Halls, Cocke County Hma, Llc and her current practice location is
434 4th St Ste 305, Newport, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(423) 415-3330.
Tara L Gustilo is licensed to practice in Ohio (license number 35084663) 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 1710913900.
Physician's Profile
| Full Name | Tara L Gustilo |
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| Gender | Female |
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| Speciality | Obstetrics/gynecology |
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| Experience | 30 Years |
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| Location | 434 4th St Ste 305, Newport, Tennessee |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Tara L Gustilo attended and graduated from Mayo Medical School in 1994
NPI Data:
- NPI Number: 1710913900
- Provider Enumeration Date: 06/23/2006
- Last Update Date: 12/05/2022
Medicare PECOS Information:
- PECOS PAC ID: 3971559238
- Enrollment ID: I20220822003030
Medical Identifiers
Medical identifiers for Tara L Gustilo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1710913900 | NPI | - | NPPES |
| 2557782 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207V00000X | Obstetrics & Gynecology | 35084663 (Ohio) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Champion Physical Therapy Llc Halls | 1355416306 | 228 |
| Cocke County Hma, Llc | 4183898562 | 2 |
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 L Gustilo allows following entities to bill medicare on her behalf.
| Entity Name | Cocke County Hma, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1104463322
PECOS PAC ID: 4183898562
Enrollment ID: O20200619000776 |
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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 L Gustilo 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 |
|---|
Tara L Gustilo, MD MPH
434 4th St Ste 305,
Newport, TN 37821-3735
Ph: (423) 415-3330 | Tara L Gustilo, MD MPH
434 4th St Ste 305,
Newport, TN 37821-3735
Ph: (423) 415-3330 |
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