NPIMap

Individual provider Active NPI

Sabo Bukar Tanimu, MD

  • Gastroenterology Physician
  • Weston, WI
National Provider Identifier
1417063793
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
51692 Issued in WI
Practice address
3501 Cranberry Blvd
Weston, WI 54476-5213
Phone
(715) 393-1000
NPI assigned
Aug 21, 2006
Last updated
Mar 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME96549 FL
Gastroenterology Physician 207RG0100X 35.147175 OH
Gastroenterology Physician 207RG0100X 51692 WI Primary

Addresses

Primary practice location

3501 Cranberry Blvd
Weston, WI 54476-5213

Mailing address

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

Other practice location 1

10600 Montgomery Rd Ste 300
Montgomery, OH 45242-4464
Phone (513) 794-5600

Other identifiers 1

IdentifierTypeStateIssuer
35306700MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, OH, ID3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20080722000672 WI Practitioner - Gastroenterology 1254404304 Reassigns benefits to 3 organizations
I20230316002165 OH Practitioner - Gastroenterology 1254404304 Reassigns benefits to 2 organizations
I20251218004650 ID Practitioner - Gastroenterology 1254404304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCHS Hospitals IncGroup PAC ID 5698071173, 1,195 clinicians
Trihealth H LLCGroup PAC ID 1850570458, 850 clinicians
St Lukes Clinic LLCGroup PAC ID 1052217478, 313 clinicians

Practice addresses (Care Compare)

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

10600 Montgomery Rd
Suite 300
Montgomery, OH 45242-4464
Phone (513) 853-9250

2727 Plaza Dr
Wausau, WI 54401-4129
Phone (715) 847-3000

3400 Ministry Pkwy
Weston, WI 54476-5220
Phone (715) 393-1000

775 Pole Line Rd W
Suite 203
Twin Falls, ID 83301-5820
Phone (208) 814-2400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy85
Upper gastrointestinal (GI) endoscopy for acid reflux233

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME96549FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Dec 24, 2018 Accepting new patients
MCHS Hospitals Inc CurrentSince Mar 16, 2019 Accepting new patients
Partners Physician Group CurrentSince Dec 6, 2023 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Dec 24, 2018 Accepting new patients
MCHS Hospitals Inc CurrentSince Mar 16, 2019 Accepting new patients
St Luke's Clinic LLC CurrentSince Oct 31, 2025 Accepting new patients
Trihealth H LLC Gastroenterology CurrentSince Apr 3, 2023 Accepting new patients
Partners Physician Group CurrentSince Dec 6, 2023 Accepting new patients
Marshfield Clinic Inc CurrentSince Jul 14, 2008 Accepting new patients
Memorial Hospital Inc Past Accepting new patients
Sports and Spine Physical Therapy NC Inc Past Accepting new patients

Locations

746 N College Rd
Ste D
Twin Falls, ID 83301
Phone (208) 814-7230

775 Pole Line Rd W
Ste 203
Twin Falls, ID 83301
Phone (208) 814-8300

1 Akron General Ave
Akron, OH 44307
Phone (330) 344-5760

224 W Exchange St
Ste 160
Akron, OH 44302
Phone (330) 344-6505

375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-2432

375 Dixmyth Ave
Ste 3135
Cincinnati, OH 45220
Phone (513) 862-3452

4685 Forest Ave
Cincinnati, OH 45212
Phone (513) 853-4721

10600 Montgomery Rd
Ste 300
Montgomery, OH 45242
Phone (513) 984-2510

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

3501 Cranberry Blvd
Weston, WI 54476
Phone (715) 393-1000

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: sabo.tanimu@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 11

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 9

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1417063793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-387-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 CRANBERRY BLVD",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544765213",
            "telephone_number": "715-393-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10600 Montgomery Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "OH",
            "postal_code": "452424464",
            "country_code": "US",
            "telephone_number": "513-794-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANIMU",
        "first_name": "SABO",
        "middle_name": "BUKAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME96549",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35.147175",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WI",
            "license": "51692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35306700",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Other",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "1000 N Oak Ave",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Weston, WI

Sources for this page

Verify at the official NPI Registry.