NPIMap

Individual provider Active NPI

Tanner Gronowski, D.O.

  • Emergency Medicine Physician
  • Canton, OH
National Provider Identifier
1366783235
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DO213513 Issued in OR
Practice address
4535 Dressler Rd NW
Canton, OH 44718
Phone
(855) 687-0618
NPI assigned
Mar 2, 2013
Last updated
Apr 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X O-1261 ID
Emergency Medicine Physician 207P00000X 34.012005 OH
Emergency Medicine Physician 207P00000X DO213513 OR Primary

Addresses

Primary practice location

4535 Dressler Rd NW
Canton, OH 44718

Mailing address

4535 Dressler Rd NW
Canton, OH 44718-2545

Other practice location 1

5100 W Broad St
Columbus, OH 43228-1607
Phone (208) 794-6263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191028002525 ID Practitioner - Emergency Medicine 6406158799 Reassigns benefits to 1 organization
I20230518000510 OR Practitioner - Emergency Medicine 6406158799 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Pacific NW Un of HS, Col of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, shared by 18 NPIs, 995 clinicians

Practice addresses (Care Compare)

323 E Riverside Dr
Eagle, ID 83616-6864
Phone (208) 367-5300

351 SW 9TH St
Ontario, OR 97914-2639
Phone (541) 881-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
O-1261IDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC Emergency Medicine CurrentSince Apr 25, 2023 Accepting new patients
St Lukes Clinic-Treasure Valley LLC Emergency Medicine CurrentSince Sep 1, 2019 Accepting new patients
Cep America, LLC Emergency Medicine CurrentSince Jan 1, 2023 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Jan 1, 2023 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients
Cep America, LLC Emergency Medicine Current Accepting new patients
Usacs of Colorado Inc Emergency Medicine Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2235

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

323 E Riverside Dr
Eagle, ID 83616
Phone (208) 302-6000

351 SW 9th St
Ontario, OR 97914
Phone (541) 881-7000

2700 NW Stewart Pkwy
Roseburg, OR 97471
Phone (541) 673-0611

Interoperability endpoints

  • Direct secure messaging: tgronowski2338889@direct.trinity-health.org

Organizations & group practices 7

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.

Hospital & facility affiliations 7

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": "1362182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1366783235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44718",
            "telephone_number": "855-687-0618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5100 W Broad St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432281607",
            "country_code": "US",
            "telephone_number": "208-794-6263",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRONOWSKI",
        "first_name": "TANNER",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-02",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "O-1261",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.012005",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "DO213513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.