Active NPI
Tanner Muggli, MD
- Emergency Medicine Physician
- Denver, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- MD222511
- Practice address
- 777 Bannock St # Mc0108
Denver, CO 80204-4507 - Phone
- (303) 602-5193
- NPI assigned
- Mar 9, 2020
- Reactivated
- Apr 14, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | MD222511 | OR | Primary |
Addresses
Primary practice location
777 Bannock St # Mc0108
Denver, CO 80204-4507
Mailing address
1959 NE Pacific St
Seattle, WA 98195-0001
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | .edu |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- University of Washington School of Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-2200
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD222511 | OR | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Acute Care Specialists PC | Emergency Medicine | Current | Accepting new patients |
| Northwest Acute Care Specialists PC | Emergency Medicine | Current | Accepting new patients |
Locations
24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407
1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582
2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200
19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212
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.
-
- Emergency Medicine Physician
- Portland, OR
- NPI 1215983200
-
dba Providence Seaside Hospital
- Critical Access Hospital
- Seaside, OR
- NPI 1578500492
-
- Emergency Medicine Physician
- Vancouver, WA
- NPI 1487811048
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Unity Center for Behavioral Health-PES
- General Acute Care Hospital
- Portland, OR
- NPI 1003367491
-
dba Legacy Laboratory Services
- Clinical Medical Laboratory
- Portland, OR
- NPI 1295756898
Hospital
-
- General Acute Care Hospital
- Portland, OR
- NPI 1831112358
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739750400000",
"number": "1124653217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1959 NE PACIFIC ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981950001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 BANNOCK ST # MC0108",
"city": "DENVER",
"state": "CO",
"postal_code": "802044507",
"telephone_number": "303-602-5193"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUGGLI",
"first_name": "TANNER",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-09",
"last_updated": "2025-02-17",
"certification_date": "2025-02-17",
"deactivation_date": "2020-06-22",
"reactivation_date": "2021-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "OR",
"license": "MD222511",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": ".edu",
"affiliation": "N",
"address_1": "1959 NE Pacific St",
"city": "Seattle",
"state": "WA",
"country_code": "US",
"postal_code": "981950001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.