Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tara L Fishback, PA-C

Individual provider Medical Physician Assistant · NPI 1528400629

Tara L Fishback, PA-C is a Physician Assistant in Traverse City, Michigan. Graduated from University of New England, College of Osteo Medicine in 2013, 13 years ago. Practices with Munson Medical Center, a 377-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Arizona, Maine, Michigan and Wisconsin.

Years since qualifying
13
Trained at
University of New England, College of Osteo Medicine
Licensed in
AZ, ME, MI, WI
In the registry since
2013
Specialties on file
4
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

1221 Sixth St Ste 300
Traverse City, MI 49684-2360
Phone: (231) 392-0640
Fax: (231) 392-0643
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 250 E Dunlap Ave, Phoenix, AZ 85020-2825 — (602) 396-7491
  • 498 Essex St Ste 105, Bangor, ME 04401-3990 — (207) 947-0558
  • 50 Union St, Ellsworth, ME 04605 — (207) 664-5405

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601010328 (MI)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 5447 (AZ)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 3747-23 (WI)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA1799 (ME)

Record details

NPI number1528400629
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 18, 2013
Last updated in NPPESJuly 19, 2021
Certification dateJuly 19, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF NEW ENGLAND, COLLEGE OF OSTEO MEDICINE
Graduated 2013 (13 years in practice)
Group practice Munson Medical Center — 377 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in Traverse City