Individual provider Active NPI

Matthew David Tentis, PA-C

  • Physician Assistant
  • Rochester, MN
National Provider Identifier
1114372968
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12107 Issued in MN
Practice address
200 1St St SW
Rochester, MN 55905-0001
Phone
(507) 284-2511
NPI assigned
Apr 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 12107 MN Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905-0001

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other practice location 1

701 Redwing Ave
Red Wing, MN 55066
Phone (507) 208-3101

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mtentis87292@ehrdirect.mayoclinicmsg.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160525002864 MN Practitioner - Physician Assistant 0840580239 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo ClinicGroup PAC ID 6507778255, 4,829 clinicians

Practice addresses (Care Compare)

1216 2ND St SW
Rochester, MN 55902-1906
Phone (507) 255-5123

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12107MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic CurrentSince Nov 6, 2023 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Mar 1, 2017 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Mar 1, 2017 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Mar 1, 2017 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Mar 1, 2017 Accepting new patients
Mayo Clinic Health System-Lake City CurrentSince May 23, 2016 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Past Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Past Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Past Accepting new patients

Locations

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

701 Hewitt Blvd
Red Wing, MN 55066
Phone (507) 377-6285

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

1650 4th St SE
Rochester, MN 55904
Phone (507) 285-8485

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

800 West Ave S
La Crosse, WI 54601
Phone (608) 372-5951

Organizations & group practices 10

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 1

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": "1461888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1114372968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Redwing Ave",
            "address_purpose": "LOCATION",
            "city": "Red Wing",
            "state": "MN",
            "postal_code": "55066",
            "country_code": "US",
            "telephone_number": "507-208-3101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TENTIS",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-29",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mtentis87292@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559050001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.