Active NPI
John Paul Tennis, PA-C
- Physician Assistant
- Duluth, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 14525
- Practice address
- 400 E 3Rd St
Duluth, MN 55805-1951 - Phone
- (218) 786-4000
- NPI assigned
- Mar 19, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1117331 | CA | |
| Physician Assistant | 363A00000X | 7809 | WI | |
| Physician Assistant | 363A00000X | 14525 | MN | Primary |
Addresses
Primary practice location
400 E 3Rd St
Duluth, MN 55805-1951
Mailing address
400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364
Other practice location 1
34800 Bob Wilson Dr
San Diego, CA 92134-1098
Phone (760) 339-2674
Other practice location 2
3500 Tower Ave
Superior, WI 54880-4491
Phone (715) 817-7100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, MN, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of Nebraska College of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1413 Hwy 33 S
Cloquet, MN 55720-2626
Phone (218) 337-4000
1600 Miller Trunk Hwy
Duluth, MN 55811-5640
Phone (218) 786-5360
400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364
4212 Grand Ave
Duluth, MN 55807-2737
Phone (218) 786-3500
4855 W Arrowhead Rd
Hermantown, MN 55811-3936
Phone (218) 786-3540
603 9TH St N
Virginia, MN 55792-2319
Phone (218) 741-3013
901 9TH St N
Virginia, MN 55792-2398
Phone (218) 748-7750
Hospital & facility affiliations
- Essentia Health Duluth
- St Marys Hospital Superior
- Essentia Health St Mary'S Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1117331 | CA | MD | Physician Assistant |
| 14525 | MN | MD | Physician Assistant |
| 7809 | WI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pine Medical Center | Current | Accepting new patients | |
| Anaheim Urgent Care, Inc. | Current | Accepting new patients | |
| The Duluth Clinic, LTD | Current | Accepting new patients | |
| The Duluth Clinic, LTD | Current | Accepting new patients | |
| The Duluth Clinic LTD | Current | Accepting new patients | |
| Moose Lake Community Hospital District | Current | Accepting new patients | |
| Essentia Health Moose Lake | Current | Accepting new patients | |
| Essentia Health Moose Lake | Current | Accepting new patients | |
| St. Mary'S Hospital of Superior | Current | Accepting new patients | |
| St. Mary'S Hospital of Superior | Current | Accepting new patients | |
| The Duluth Clinic, LTD. | Current | Accepting new patients | |
| Anaheim Urgent Care, Inc. | Current | Accepting new patients |
Locations
831 S State College Blvd
Anaheim, CA 92806
Phone (714) 533-2273
6010 Hidden Valley Rd
Ste 150
Carlsbad, CA 92011
Phone (760) 544-8233
1300 N La Brea Ave
Los Angeles, CA 90028
Phone (323) 464-1336
5717 Melrose Ave
Los Angeles, CA 90038
Phone (323) 957-2273
888 S Figueroa St
Ste 600
Los Angeles, CA 90017
35 W Los Angeles Ave
Moorpark, CA 93021
Phone (805) 529-5370
400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364
4212 Grand Ave
Duluth, MN 55807
Phone (218) 786-3500
400 E 3rd St
#6
Duluth, MN 55805
Phone (320) 360-1676
4855 W Arrowhead Rd
Hermantown, MN 55811
Phone (218) 786-3540
4572 County Road 61
Moose Lake, MN 55767
Phone (218) 485-4481
705 Lundorff Dr
Sandstone, MN 55072
Phone (320) 245-2211
603 9th St N
Virginia, MN 55792
Phone (218) 741-3013
3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281
Organizations & group practices 15
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.
-
- Multi-Specialty Clinic/Center
- Cloquet, MN
- NPI 1902563638
-
- Critical Access Hospital
- Moose Lake, MN
- NPI 1154959880
-
- Urgent Care Clinic/Center
- Anaheim, CA
- NPI 1962680033
-
- Critical Access Hospital
- Superior, WI
- NPI 1083657886
-
- Critical Access Hospital
- Sandstone, MN
- NPI 1326041633
-
- Rehabilitation Clinic/Center
- Duluth, MN
- NPI 1639237746
-
- Critical Access Hospital Clinic/Center
- Moose Lake, MN
- NPI 1275102048
-
- Critical Access Hospital
- Moose Lake, MN
- NPI 1942398029
-
- Multi-Specialty Clinic/Center
- Hinckley, MN
- NPI 1720859531
-
- Multi-Specialty Clinic/Center
- Hermantown, MN
- NPI 1003478892
-
- Multi-Specialty Clinic/Center
- Hermantown, MN
- NPI 1235176058
-
- Multi-Specialty Clinic/Center
- Duluth, MN
- NPI 1669410221
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Duluth, MN
- NPI 1457393035
-
- Critical Access Hospital
- Superior, WI
- NPI 1083657886
-
- Critical Access Hospital Clinic/Center
- Superior, WI
- NPI 1588691588
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736208000000",
"number": "1376667063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 E 3RD ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558051951",
"telephone_number": "218-786-8364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 E 3RD ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558051951",
"telephone_number": "218-786-4000"
}
],
"practiceLocations": [
{
"address_1": "34800 Bob Wilson Dr",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921341098",
"country_code": "US",
"telephone_number": "760-339-2674",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3500 Tower Ave",
"address_purpose": "LOCATION",
"city": "Superior",
"state": "WI",
"postal_code": "548804491",
"country_code": "US",
"telephone_number": "715-817-7100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TENNIS",
"first_name": "JOHN",
"middle_name": "PAUL",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-19",
"last_updated": "2025-01-07",
"certification_date": "2025-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "1117331",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "7809",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "14525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Duluth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.