Tanner Jesus Verduzco

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

12000 Elm Creek Blvd N Ste 300
Maple Grove, MN 55369-7075

Phone

(952) 841-2345

Fax

(952) 841-2346

NPI assigned

Oct 14, 2021

Last updated

Dec 21, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Andrew J Will MD PAGroup PAC ID 9830152495, 36 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

79.75 of 100Reported as group

Quality

42.73

Promoting interoperability

96

Improvement activities

40

Cost

66.97

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tanner.verduzco.p1@direct.tcpain.nextgenshare.com

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

• Andrew J Will MD PA

  dba Twin Cities Pain Clinic

  • Physical Medicine & Rehabilitation Physician
  • Edina, MN
  • NPI 1215003066
  Medicare reassignment Care Compare group NPD (past)
• Andrew J Will MD PA

  dba Twin Cities Pain Clinic

  • Pain Clinic/Center
  • Chaska, MN
  • NPI 1669167920
  NPD
• Infinite Health Collaborative, PA

  • Orthopaedic Surgery Physician
  • Bloomington, MN
  • NPI 1164474250
  NPD (past)

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

{
    "created_epoch": "1634169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1073276259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7235 OHMS LN",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392148",
            "telephone_number": "952-841-2345",
            "fax_number": "952-841-2346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12000 ELM CREEK BLVD N STE 300",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697075",
            "telephone_number": "952-841-2345",
            "fax_number": "952-841-2346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7235 Ohms Ln",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554392148",
            "country_code": "US",
            "telephone_number": "952-841-2345",
            "fax_number": "952-841-2346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERDUZCO",
        "first_name": "TANNER",
        "middle_name": "JESUS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-14",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Michelle Vanhorn
• Vanessa Vasquez Cerrito
• Venetia Laganis, DDS, PA
• Sarah Nicole Olson Venning, LICSW
• Alissa S Ventura, PA-C
• Johanna Maria Viau Colindres, M.D.
• Jacqueline Luna Vior
• Lorilee Virnig
• Graham Tyler Virtue, PA-S
• Vision World Inc (Vision World)

• Physician Assistant in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.