Individual provider Active NPI

Dorian J Tennant, PAC

  • Physician Assistant
  • Abington, PA
National Provider Identifier
1205814647
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA050720 Issued in PA
Practice address
1200 Old York Rd
Abington, PA 19001-3720
Phone
(215) 481-4355
Fax
(215) 481-4629
NPI assigned
Jan 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MA050720 PA Primary

Addresses

Primary practice location

1200 Old York Rd
Abington, PA 19001-3720

Mailing address

PO Box 3012
Wilmington, DE 19804-0012
Phone (800) 456-4629

Other names 1

  • Dorian J Reigner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20120828000053 MI Practitioner - Physician Assistant 1658479241 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA050720PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Physician Assistant CurrentSince Dec 12, 2016 Accepting new patients
Henry Ford Health System CurrentSince Dec 12, 2016 Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

1 Ford Pl
Detroit, MI 48202
Phone (313) 874-4118

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

3500 15 Mile Rd
Sterling Hts, MI 48310
Phone (586) 977-9300

Interoperability endpoints

  • Direct secure messaging: dtennant435292@direct.hfhs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205814647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3012",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198040012",
            "telephone_number": "800-456-4629",
            "fax_number": "302-224-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 OLD YORK RD",
            "city": "ABINGTON",
            "state": "PA",
            "postal_code": "190013720",
            "telephone_number": "215-481-4355",
            "fax_number": "215-481-4629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNANT",
        "first_name": "DORIAN",
        "middle_name": "J",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA050720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DORIAN",
            "last_name": "REIGNER",
            "middle_name": "J",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Abington, PA

Sources for this page

Verify at the official NPI Registry.