Individual provider Active NPI

Tanaporn Rasameesoraj, M.D.

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • St Louis Park, MN
National Provider Identifier
1649534496
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084S0012X
License
79290 Issued in MN
Practice address
3931 Louisiana Ave S
St Louis Park, MN 55426-5000
Phone
(985) 299-3323
Fax
(952) 993-1748
NPI assigned
Jun 26, 2012
Last updated
May 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Neurology Physician 2084N0400X 01082567A IN
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 125071614 IL
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 79290 MN Primary

Addresses

Primary practice location

3931 Louisiana Ave S
St Louis Park, MN 55426-5000

Mailing address

8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516

Other practice location 1

676 N Saint Clair St Ste 7-701
Chicago, IL 60611-2927
Phone (312) 926-4197

Other practice location 2

676 N Saint Clair St Ste 7-701
Chicago, IL 60611-2927
Phone (312) 926-4197

Other practice location 3

4233 Gateway Blvd
Newburgh, IN 47630
Phone (812) 477-1560

Other identifiers 1

IdentifierTypeStateIssuer
1649534496OtherNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY, MN3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20190904001106 IN Practitioner - Neurology 7315283827 Reassigns benefits to 2 organizations
I20200901001351 KY Practitioner - Sleep MedicinePractitioner - Neurology 7315283827 Reassigns benefits to 1 organization
I20250522000471 MN Practitioner - Sleep Medicine 7315283827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sleep Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

3931 Louisiana Ave S
St Louis Park, MN 55426-5000
Phone (952) 993-3123

4155 County Rd 101
Plymouth, MN 55446-2307
Phone (952) 993-8900

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone (952) 993-3123

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79290MNMDSleep Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic Inc. Neurology CurrentSince Aug 1, 2019 Accepting new patients
Park Nicollet Clinic CurrentSince Jun 2, 2025 Accepting new patients
Deaconess Clinic Inc CurrentSince Aug 1, 2019 Accepting new patients
Deaconess Hospital, Inc Neurology Current Accepting new patients
Deaconess Hospital, Inc Sleep Medicine CurrentSince Jul 1, 2020 Accepting new patients
Deaconess Hospital Inc CurrentSince Aug 1, 2019 Accepting new patients
Gibson General Hospital, Inc CurrentSince Oct 1, 2020 Accepting new patients
Deaconess Clinic Inc. Current Accepting new patients
Park Nicollet Clinic Current Accepting new patients
Deaconess Hospital, Inc Sleep Medicine CurrentSince Aug 1, 2019 Accepting new patients

Locations

350 W Columbia St
Ste 210
Evansville, IN 47710
Phone (812) 450-3852

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

4600 W Lloyd Expy
Evansville, IN 47712
Phone (812) 450-6311

7307 E Columbia St
Ste 101
Evansville, IN 47715
Phone (812) 473-1737

4233 Gateway Blvd
Newburgh, IN 47630
Phone (812) 474-7116

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

1808 Sherman Dr
Ste 2209
Princeton, IN 47670
Phone (812) 385-9420

1305 N Elm St
Henderson, KY 42420
Phone (270) 827-7100

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

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

3931 Louisiana Ave S
St Louis Park, MN 55426
Phone (952) 993-3230

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 8

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": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1649534496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3931 LOUISIANA AVE S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554265000",
            "telephone_number": "985-299-3323",
            "fax_number": "952-993-1748"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "676 N Saint Clair St Ste 7-701",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112927",
            "country_code": "US",
            "telephone_number": "312-926-4197",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "676 N Saint Clair St Ste 7-701",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112927",
            "country_code": "US",
            "telephone_number": "312-926-4197",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4233 Gateway Blvd",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "IN",
            "postal_code": "47630",
            "country_code": "US",
            "telephone_number": "812-477-1560",
            "fax_number": "812-477-1595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RASAMEESORAJ",
        "first_name": "TANAPORN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-26",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "01082567A",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "IL",
            "license": "125071614",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "MN",
            "license": "79290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1649534496",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.