Douglas George Tani, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

22264 Issued in MN

Practice address

7125 Tamarack Rd Ste 100
Woodbury, MN 55125-1308

Phone

(952) 888-5800

Fax

(952) 567-6156

NPI assigned

Feb 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1295707958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9801 DUPONT AVE S",
            "address_2": "STE 425",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554313873",
            "telephone_number": "952-888-5800",
            "fax_number": "952-567-6156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7125 TAMARACK RD STE 100",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251308",
            "telephone_number": "952-888-5800",
            "fax_number": "952-567-6156"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 Exchange St W",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551021045",
            "country_code": "US",
            "telephone_number": "651-227-8275",
            "fax_number": "651-298-0160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANI",
        "first_name": "DOUGLAS",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "22264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149280200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Donald Sypura, M.D.
• Onni Jonatan Syvanto, PT
• Karen P Ta, MD
• Maegen Tabor, R.N.
• Abegeya Tadese
• Matthew Tarabochia-Gast, MD
• Basir U Tareen, MD
• Jayden Taylor
• Samuel Zachary Taylor
• Terri Taylor, MS, LMFT

• Ophthalmology Physician in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Ophthalmology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.