Individual provider Active NPI

Tanner Stippich

  • Physician Assistant
  • Lima, OH
National Provider Identifier
1053924415
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
801 Medical Dr Ste a
Lima, OH 45804-4030
Phone
(419) 222-6622
Fax
(419) 224-0015
NPI assigned
Aug 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 50007469RX OH
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

801 Medical Dr Ste a
Lima, OH 45804-4030

Mailing address

801 Medical Dr Ste a
Lima, OH 45804-4030
Phone (192) 226-6224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220221002149 OH Practitioner - Physician Assistant 1658765474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic Institute of Ohio, IncGroup PAC ID 2860479078, 74 clinicians

Practice addresses (Care Compare)

1180 Professional Dr
Van Wert, OH 45891-2461
Phone (419) 238-9764

1250 S Washington St
Van Wert, OH 45891-2551
Phone (419) 222-6622

1501 Bright Rd
Findlay, OH 45840-5463
Phone (419) 222-6622

730 W Market St
Lima, OH 45801-4602
Phone (419) 222-6622

801 Medical Dr
Lima, OH 45804-4030
Phone (419) 222-6622

Hospital & facility affiliations

  • Institute for Orthopaedic Surgery Hospital, Lima, OH, CCN 360263
  • Mercy Health St Ritas Medical Center Hospital, Lima, OH, CCN 360066
  • Lima Memorial Health System Hospital, Lima, OH, CCN 360009
  • Van Wert County Hospital Hospital, Van Wert, OH, CCN 360071

Merit-based Incentive Payment System (MIPS)

Final score
78.77 of 100Reported as group
Quality
62.75
Promoting interoperability
92
Improvement activities
40
Cost
73.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50007469RXOHMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Institute of Ohio, Inc. CurrentSince Feb 14, 2022 Accepting new patients
Orthopaedic Institute of Ohio, Inc CurrentSince Feb 14, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1501 Bright Rd
Findlay, OH 45840
Phone (419) 424-0131

801 Medical Dr
Ste A
Lima, OH 45804
Phone 41922266223301

801 Medical Dr
Lima, OH 45804
Phone (419) 227-0205

1180 Professional Dr
Van Wert, OH 45891
Phone (419) 238-9764

Organizations & group practices 3

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 5

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

NPI Registry JSON

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1053924415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 MEDICAL DR STE A",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458044030",
            "telephone_number": "192-226-6224",
            "fax_number": "419-224-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MEDICAL DR STE A",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458044030",
            "telephone_number": "419-222-6622",
            "fax_number": "419-224-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIPPICH",
        "first_name": "TANNER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-26",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50007469RX",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.