Griffin David Tanenbaum, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085008304 Issued in IL

Practice address

2500 Rocky Mountain Ave Ste 100
Loveland, CO 80538-9004

Phone

(970) 221-1000

NPI assigned

Apr 26, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Rush Medical College of Rush University, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868
  Medicare reassignment Care Compare group NPD
• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Medical Center of the Rockies

  • General Acute Care Hospital
  • Greeley, CO
  • NPI 1104262286
  Care Compare affiliation
• Medical Center of the Rockies

  • General Acute Care Hospital
  • Loveland, CO
  • NPI 1750392304
  Care Compare affiliation
• Medical Center of the Rockies

  • General Acute Care Hospital
  • Greeley, CO
  • NPI 1780243055
  Care Compare affiliation

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

{
    "created_epoch": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669334400000",
    "number": "1568044733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4309 W MEDICAL CENTER DR STE A200",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508437",
            "telephone_number": "815-759-8070",
            "fax_number": "815-759-4931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ROCKY MOUNTAIN AVE STE 100",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389004",
            "telephone_number": "970-221-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10370 Haligus Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Huntley",
            "state": "IL",
            "postal_code": "601429582",
            "country_code": "US",
            "telephone_number": "815-759-8070",
            "fax_number": "815-759-4931",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4309 W Medical Center Dr Ste A200",
            "address_purpose": "LOCATION",
            "city": "McHenry",
            "state": "IL",
            "postal_code": "600508437",
            "country_code": "US",
            "telephone_number": "815-759-8070",
            "fax_number": "815-759-4931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANENBAUM",
        "first_name": "GRIFFIN",
        "middle_name": "DAVID",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-26",
        "last_updated": "2022-11-25",
        "certification_date": "2022-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085008304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margery M Szczerba, DDS
• T Castellano MD LLC
• Taft Hill Orthodontics of Loveland
• Amy McCracken Takken, RN
• John Peyton Taliaferro, MD
• Tanner Vision PC
• Tanner Vision PC
• Kevin A Tanner, O.D.
• Louis Tartaglia Jr., MD
• Yvette Elizabeth Tataje, D.D.S.

• Physician Assistant in Loveland, CO
• Providers in Loveland, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2022; 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.

Verify at the official NPI Registry.