Individual provider Active NPI

Tjorvi E Perry, M.D.

  • Anesthesiology Physician
  • Minneapolis, MN
National Provider Identifier
1457395246
Registry record updated Jan 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
53962 Issued in MN
Practice address
500 Harvard St SE
Minneapolis, MN 55455-0363
Phone
(612) 273-3000
Fax
(612) 273-4370
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 53962 MN Primary
Anesthesiology Physician 207L00000X 214385 MA

Addresses

Primary practice location

500 Harvard St SE
Minneapolis, MN 55455-0363

Mailing address

2828 Chicago Ave
Suite 300
Minneapolis, MN 55407-1573
Phone (612) 871-7639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20120202000573 MN Practitioner - Anesthesiology 3274536768 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
214385MAMDAnesthesiology Physician
53962MNMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Anesthesia Providers, LLC Anesthesiology CurrentSince Apr 1, 2018 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc Anesthesiology CurrentSince Aug 10, 2024 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Aug 10, 2024 Accepting new patients
Northwest Anesthesia, P.a. Past Accepting new patients
Northwest Anesthesia P.a. Past Accepting new patients

Locations

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

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.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515456000000",
    "number": "1457395246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 CHICAGO AVE",
            "address_2": "SUITE 300",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071573",
            "telephone_number": "612-871-7639",
            "fax_number": "612-872-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HARVARD ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550363",
            "telephone_number": "612-273-3000",
            "fax_number": "612-273-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "TJORVI",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2018-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "53962",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "214385",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.