Individual provider Active NPI

Tanner Chriss Eiden, DO

  • Internal Medicine Physician
  • Pensacola, FL
National Provider Identifier
1235425158
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS11968 Issued in FL
Practice address
5120 Bayou Blvd
Pensacola, FL 32503-2193
Phone
(850) 432-3692
NPI assigned
Jun 20, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X OS11968 FL
Hospitalist PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208M00000X OS11968 FL
Internal Medicine Physician 207R00000X OS11968 FL Primary

Addresses

Primary practice location

5120 Bayou Blvd
Pensacola, FL 32503-2193

Mailing address

5120 Bayou Blvd
Pensacola, FL 32503-2193
Phone (850) 432-3692

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140522001235 FL Practitioner - Internal MedicinePractitioner - Hospitalist 9436372364 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infectious Disease Group, PAGroup PAC ID 9537197074, 3 clinicians

Practice addresses (Care Compare)

1717 N E St
Suite 439
Pensacola, FL 32501-6337
Phone (850) 432-3692

5120 Bayou Blvd
Suite 11
Pensacola, FL 32503-2135

Hospital & facility affiliations

  • Santa Rosa Medical Center Hospital, Milton, FL, CCN 100124
  • Baptist Hospital Hospital, Pensacola, FL, CCN 100093
  • Gulf Breeze Hospital Hospital, Gulf Breeze, FL, CCN 100266
  • Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025
  • Jay Hospital Hospital, Jay, FL, CCN 101315

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS11968FLMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
App of Florida HM, LLC Single Specialty CurrentSince Nov 21, 2018 Accepting new patients
Hospital Physician Services of Florida PA Single Specialty CurrentSince Jul 1, 2016 Accepting new patients
Infectious Disease Group, PA Single Specialty CurrentSince Oct 1, 2023 Accepting new patients
Hospital Medicine Services of FL, LLC Single Specialty CurrentSince Apr 1, 2023 Accepting new patients
Floridian Hospitalist Services, LLC Single Specialty Current Accepting new patients

Locations

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

340 NW Commerce Dr
Lake City, FL 32055
Phone (386) 719-9000

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

6002 Berryhill Rd
Milton, FL 32570
Phone (850) 474-8688

2190 Highway 85 N
Niceville, FL 32578
Phone (850) 678-4131

611 Zeagler Dr
Palatka, FL 32177
Phone (386) 326-8070

1717 N E St
Ste 439
Pensacola, FL 32501
Phone (850) 432-3692

8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212

Organizations & group practices 5

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 5

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": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1235425158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5120 BAYOU BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032193",
            "telephone_number": "850-432-3692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 BAYOU BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032193",
            "telephone_number": "850-432-3692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIDEN",
        "first_name": "TANNER",
        "middle_name": "CHRISS",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-20",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "OS11968",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "OS11968",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS11968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.