DR. TARA KAY PELLETIER DO
NPI 1124016118
Family Medicine in Biddeford, ME


Quality Rating: 29.31 out of 100 score

NPI Status: Active since October 12, 2005

Contact Information

11 HILLS BEACH RD
BIDDEFORD, ME
ZIP 04005
Phone: (207) 602-2358
Fax: (207) 602-5904

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  • Individual
  • Female
  • Family Medicine
  • Accepts Insurance
  • PECOS Enrolled

About TARA PELLETIER

This page provides the complete NPI Profile along with additional information for Tara Pelletier, a primary care provider established in Biddeford, Maine with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1124016118 assigned on October 2005. The practitioner's primary taxonomy code is 207Q00000X with license number DO1957 (ME). The provider is registered as an individual and her NPI record was last updated one year ago.

NPI
1124016118
Provider Name
DR. TARA KAY PELLETIER DO
Gender
Female
Entity Type
Individual
Location Address
11 HILLS BEACH RD BIDDEFORD, ME 04005
Location Phone
(207) 602-2358
Location Fax
(207) 602-5904
Mailing Address
PO BOX 284 BRATTLEBORO, VT 05302
Mailing Phone
(207) 602-2358
Mailing Fax
(207) 602-5904
Is Sole Proprietor?
No
Enumeration Date
10-12-2005
Last Update Date
08-12-2024
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A primary care provider (PCP) like Tara Pelletier sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Secondary Locations

  • 716 Stevens Ave
    Portland, ME 04103
    (207) 221-4242

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
DO1957
License State
ME
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

224963 (MA)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Access Blue New England HMO 5000/10%/8000 w/HSA - HMO
  • Anthem Bronze Access Blue New England HMO 5000/20%/8000 w/HSA - HMO
  • Anthem Bronze Access Blue New England HMO 6500/30%/9200 Value - HMO
  • Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
  • Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
  • Anthem Gold Access Blue New England HMO 1000/20%/7500 - HMO
  • Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
  • Anthem Gold Access Blue New England HMO 2000/10%/4600 w/HSA - HMO
  • Anthem Gold Access Blue New England HMO 2000/10%/7500 - HMO
  • Anthem Gold Access Blue New England HMO 2000/20%/4600 w/HSA - HMO
  • Anthem Gold Access Blue New England HMO 3000/0%/5500 RxD - HMO
  • Anthem Gold Access Blue New England HMO 500/25%/7000 - HMO
  • Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
  • Anthem Silver Access Blue New England HMO 2000/30%/9000 Value - HMO
  • Anthem Silver Access Blue New England HMO 3000/20%/8500 - HMO
  • Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
  • Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
  • Anthem Silver Access Blue New England HMO 4000/0%/8500 - HMO
  • Anthem Silver Access Blue New England HMO 4000/0%/8500 RxD - HMO
  • Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Tara Pelletier is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 04005 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $86.72
  • Minimum New Patient Price $56.28
  • Maximum New Patient Price $169.96
  • Average New Patient Copayment $21.68
  • Minimum New Patient Copayment $14.07
  • Maximum New Patient Copayment $42.49

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $99.18
  • Minimum Established Patient Price $18.22
  • Maximum Established Patient Price $138.92
  • Average Established Patient Copayment $24.79
  • Minimum Established Patient Copayment $4.55
  • Maximum Established Patient Copayment $34.73

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 29.31, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 29.31 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 0

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 0

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 20

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: 72.7

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: 72.7

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Reviews for DR. TARA KAY PELLETIER DO

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1124016118
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2144011212
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 4 + 4 + 0 + 1 + 1 + 2 + 1 + 2 + 24 = 42
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 42 = 88

The NPI number 1124016118 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1396730198DR. STEPHEN CURTIS SHANNON D.O.
Individual
Family Medicine11 HILLS BEACH RD UNECOM
BIDDEFORD, ME 04005
(207) 283-0171
1912992686PROF. WAYNE RICHARD LAMARRE MED, ATC, LAT
Individual
Specialist11 HILLS BEACH RD
BIDDEFORD, ME 04005
(207) 602-2412
1104801067 BOYD R BUSER D.O.
Individual
Neuromusculoskeletal Medicine & OMM11 HILLS BEACH RD
BIDDEFORD, ME 04005
(207) 284-1417
1023094968 BARRY BUTLER P.T.
Individual
Physical Therapist (Orthopedic)11 HILLS BEACH RD
BIDDEFORD, ME 04005
(207) 284-8650
1437136264 MICHAEL SHELDON P.T.
Individual
Physical Therapist11 HILLS BEACH RD
BIDDEFORD, ME 04005
(207) 284-8650
1659333672 SALLY MCCORMACK PT
Individual
Physical Therapist11 HILLS BEACH RD
BIDDEFORD, ME 04005
(207) 602-2845
1982912895 MARC B HAHN DO
Individual
Anesthesiology11 HILLS BEACH RD
BIDDEFORD, ME 04005
(207) 602-2807
1215043757 MARYLOU BURGESS NP
Individual
Nurse Practitioner (Family)11 HILLS BEACH RD
BIDDEFORD, ME 04005
(207) 602-2358
1396896650 KAREN SAUCIER NP
Individual
Nurse Practitioner11 HILLS BEACH RD
BIDDEFORD, ME 04005
(207) 602-2358
1306961180MS. ELIZABETH P MULLANY PMHNP
Individual
Nurse Practitioner (Psychiatric/Mental Health)11 HILLS BEACH RD
BIDDEFORD, ME 04005
(207) 602-2358
1407802341 LAUREL B SHEPPARD FNP
Individual
Nurse Practitioner (Family)11 HILLS BEACH RD
BIDDEFORD, ME 04005
(207) 602-2358
1801249305 ERICA S BURKHART NP
Individual
Registered Nurse (General Practice)11 HILLS BEACH RD
BIDDEFORD, ME 04005
(207) 602-2358
1750803128 REBECCA RACHEL DREW-MOYER AT
Individual
Specialist/Technologist (Athletic Trainer)11 HILLS BEACH RD
BIDDEFORD, ME 04005
(603) 568-3657
1083137731 ERIK ANDERSON
Individual
Specialist/Technologist (Athletic Trainer)11 HILLS BEACH RD
BIDDEFORD, ME 04005
(603) 845-8226
1760998462 JASMINE HONEY MS, LAT, ATC, CSCS
Individual
Specialist/Technologist (Athletic Trainer)11 HILLS BEACH RD
BIDDEFORD, ME 04005
(207) 602-2381
1730696998 CHRISTOPHER S RIZZO ATC, CSCS
Individual
Specialist/Technologist (Athletic Trainer)11 HILLS BEACH RD
BIDDEFORD, ME 04005
(207) 602-2465
1518475920 JOHANNA WALSH
Individual
Specialist/Technologist (Athletic Trainer)11 HILLS BEACH RD
BIDDEFORD, ME 04005
(978) 766-4480
1609384015 SAMANTHA ROSE CELLA
Individual
Specialist/Technologist (Athletic Trainer)11 HILLS BEACH RD
BIDDEFORD, ME 04005
(774) 276-5794
1134637424 SHELBY ELIZABETH SANTOR
Individual
Student in an Organized Health Care Education/Training Program11 HILLS BEACH RD
BIDDEFORD, ME 04005
(207) 283-0171
1982112199 KATHRYN DOUGLAS
Individual
Specialist/Technologist (Athletic Trainer)11 HILLS BEACH RD
BIDDEFORD, ME 04005
(978) 855-3785

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1124016118, enumerated in the NPI registry as an "individual" on October 12, 2005

The provider is located at 11 Hills Beach Rd Biddeford, Me 04005 and the phone number is (207) 602-2358

The provider's speciality is Family Medicine with taxonomy code 207Q00000X

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Medicare beneficiaries should expect a typical cost of $86.72 with an average copayment of $21.68 for new patient appointments. Established patients should expect a typical charge of $99.18 and an average copayment of 24.79. Please review your insurance plan or contact the provider directly to determine your specific costs.

This NPI record was last updated on October 12, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.