Individual provider Active NPI

Karl Stuart Tjerandsen, M.D.

  • Internal Medicine Physician
  • Walla Walla, WA
National Provider Identifier
1487077566
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD61486738 Issued in WA
Practice address
401 W Poplar St
Walla Walla, WA 99362-2846
Phone
(509) 897-3320
NPI assigned
Jan 27, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 66833 MN
Internal Medicine Physician 207R00000X MD61486738 WA Primary

Addresses

Primary practice location

401 W Poplar St
Walla Walla, WA 99362-2846

Mailing address

401 W Poplar St
Walla Walla, WA 99362-2846

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200721001287 MN Practitioner - Internal Medicine 2466717475 Reassigns benefits to 4 organizations
I20240107000022 WA Practitioner - Hospitalist 2466717475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Oregon Health Sciences University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

401 W Poplar St
Walla Walla, WA 99362-2846
Phone (509) 897-3320

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66833MNMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hutchinson Health CurrentSince Jun 1, 2023 Accepting new patients
Allina Health System CurrentSince Aug 31, 2020 Accepting new patients
Group Health, Inc. CurrentSince Jan 9, 2023 Accepting new patients
Group Health, Inc. Current Accepting new patients
Providence Health & Services - Washington Internal Medicine CurrentSince Jan 15, 2024 Accepting new patients
Park Nicollet Clinic CurrentSince Jan 9, 2023 Accepting new patients
Park Nicollet Clinic Current Accepting new patients
Allina Health System CurrentSince Aug 31, 2020 Accepting new patients
Allina Health System Current Accepting new patients
Providence Health & Services Washington CurrentSince Jan 15, 2024 Accepting new patients
Group Health, Inc. CurrentSince Jan 9, 2023 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients

Locations

1029 Highway 15 S
Hutchinson, MN 55350
Phone (320) 275-3358

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

420 Delaware St SE
Ste MMC284
Minneapolis, MN 55455
Phone (612) 625-5454

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

6500 Excelsior Blvd
St Louis Park, MN 55426
Phone (952) 993-3246

380 Chase Ave
Walla Walla, WA 99362
Phone (509) 526-3333

401 W Poplar St
Walla Walla, WA 99362
Phone (509) 522-5731

Organizations & group practices 12

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.

Hospital & facility affiliations 4

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": "1390780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1487077566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W POPLAR ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W POPLAR ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622846",
            "telephone_number": "509-897-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TJERANDSEN",
        "first_name": "KARL",
        "middle_name": "STUART",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-27",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "66833",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD61486738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walla Walla, WA

Sources for this page

Verify at the official NPI Registry.