NPIMap

Individual provider Active NPI

Garth B Tanner, MD

  • Internal Medicine Physician
  • Modesto, CA
National Provider Identifier
1184612624
Registry record updated Jul 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A64407 Issued in CA
Practice address
1429 College Ave
Ste K
Modesto, CA 95350-4057
Phone
(209) 521-7800
Fax
(209) 521-5733
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A64407 CA Primary

Addresses

Primary practice location

1429 College Ave
Ste K
Modesto, CA 95350-4057

Mailing address

PO Box 3812
Modesto, CA 95352-3812
Phone (209) 521-7800

Other identifiers 1

IdentifierTypeStateIssuer
00A644070MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071204000366 CA Practitioner - Internal Medicine 8729092465 Receives reassigned benefits from 2 practitioners
Practice locations: Modesto, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Loma Linda University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1429 College Ave
Suite K
Modesto, CA 95350-4046

1429 College Ave K
Modesto, CA 95350-4046
Phone (209) 521-7800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
30.35 of 100Reported as individual
Quality
20
Improvement activities
0
Cost
74.5

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Medical Center of Modesto, Inc. Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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 6

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": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342051200000",
    "number": "1184612624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3812",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953523812",
            "telephone_number": "209-521-7800",
            "fax_number": "209-521-1329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1429 COLLEGE AVE",
            "address_2": "STE K",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504057",
            "telephone_number": "209-521-7800",
            "fax_number": "209-521-5733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "GARTH",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2012-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A64407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A644070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.