Mrs Tara Robertson, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Mount Sterling, Illinois. She graduated from nursing school in 2014 and has 12 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Riverside Dermatology And Spa Llc and her current practice location is
1 Dot Way, Mount Sterling, Illinois. You can reach out to her office (for appointments etc.) via phone at
(217) 773-6060.
Mrs Tara Robertson is licensed to practice in Illinois (license number 209012568) 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 1104204122.
Provider's Profile
| Full Name | Mrs Tara Robertson |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 12 Years |
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| Location | 1 Dot Way, Mount Sterling, Illinois |
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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:
- Mrs Tara Robertson graduated from nursing school in 2014
NPI Data:
- NPI Number: 1104204122
- Provider Enumeration Date: 05/11/2015
- Last Update Date: 03/26/2019
Medicare PECOS Information:
- PECOS PAC ID: 2062707961
- Enrollment ID: I20200513002515
Medical Identifiers
Medical identifiers for Mrs Tara Robertson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1104204122 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 209012568 (Illinois) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Riverside Dermatology And Spa Llc | 7214282227 | 6 |
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. Mrs Tara Robertson allows following entities to bill medicare on her behalf.
| Entity Name | Riverside Dermatology & Spa Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1699262329
PECOS PAC ID: 7214282227
Enrollment ID: O20180615000066 |
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| Entity Name | Integrated Dermatology Of Northeast Missouri Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1992518658
PECOS PAC ID: 5698293108
Enrollment ID: O20250519002195 |
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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. Mrs Tara Robertson 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 |
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Mrs Tara Robertson, FNP-C
1531 Winsor Dr,
Quincy, IL 62305-1471
Ph: (217) 440-5089 | Mrs Tara Robertson, FNP-C
1 Dot Way,
Mount Sterling, IL 62353-1664
Ph: (217) 773-6060 |
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