Individual provider Active NPI

Tiffany T Panait, M.D.

  • Colon & Rectal Surgery Physician
  • Maple Grove, MN
National Provider Identifier
1023276789
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
55610 Issued in MN
Practice address
9825 Hospital Dr Ste 300
Maple Grove, MN 55369-4768
Phone
(763) 587-7900
Fax
(763) 494-7501
NPI assigned
May 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 55610 MN Primary

Addresses

Primary practice location

9825 Hospital Dr Ste 300
Maple Grove, MN 55369-4768

Mailing address

9201 W Broadway Ave Ste 601
Brooklyn Park, MN 55445-1924
Phone (763) 587-7900

Other practice location 1

15655 37th Ave N Ste 100
Plymouth, MN 55446-4003
Phone (763) 587-7900

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tiffany.fancher@nor.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120912000221 MN Practitioner - Colorectal Surgery (Proctology) 1658529995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Clinic PAGroup PAC ID 2769384205, 50 clinicians

Practice addresses (Care Compare)

9825 Hospital Dr
Suite 300
Maple Grove, MN 55369-4768
Phone (763) 587-7900

Hospital & facility affiliations

  • North Memorial Health Hospital Hospital, Robbinsdale, MN, CCN 240001
  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
55610MNMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Clinic, PA CurrentSince May 1, 2020 Accepting new patients
North Clinic, PA Colon & Rectal Surgery CurrentSince May 1, 2020 Accepting new patients

Locations

9825 Hospital Dr
Ste 300
Maple Grove, MN 55369
Phone (763) 494-7500

9201 W Broadway Ave
Ste 601
Minneapolis, MN 55445
Phone (763) 587-7933

50 Central Ave
Osseo, MN 55369
Phone (612) 588-4625

15655 37th Ave N
Ste 100
Plymouth, MN 55446
Phone (612) 293-7822

3366 Oakdale Ave N
Ste 215
Robbinsdale, MN 55422
Phone (612) 588-4625

3366 Oakdale Ave N
Ste 315
Robbinsdale, MN 55422
Phone (763) 520-7900

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1023276789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 W BROADWAY AVE STE 601",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554451924",
            "telephone_number": "763-587-7900",
            "fax_number": "763-587-7066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9825 HOSPITAL DR STE 300",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694768",
            "telephone_number": "763-587-7900",
            "fax_number": "763-494-7501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15655 37th Ave N Ste 100",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MN",
            "postal_code": "554464003",
            "country_code": "US",
            "telephone_number": "763-587-7900",
            "fax_number": "763-587-7701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANAIT",
        "first_name": "TIFFANY",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-29",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "MN",
            "license": "55610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tiffany.fancher@nor.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "9825 Hospital Dr Ste 300",
            "city": "Maple Grove",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553694768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.