Active NPI
Mary Anne Tinguely
- Pediatric Physical Therapist
- New Hope, MN
National Provider Identifier
1659414530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 9273
- Practice address
- 9220 Bass Lake Rd Ste 260
New Hope, MN 55428-3019 - Phone
- (763) 533-0363
- NPI assigned
- Feb 14, 2007
- Last updated
- Mar 8, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT1378 | ME | |
| Pediatric Physical Therapist | 2251P0200X | 9760 | CO | |
| Pediatric Physical Therapist | 2251P0200X | 9273 | MN | Primary |
Addresses
Primary practice location
9220 Bass Lake Rd Ste 260
New Hope, MN 55428-3019
Mailing address
719 McGraw Dr
Fort Collins, CO 80526-3978
Phone (970) 222-8274
Other practice location 1
719 McGraw Dr
Fort Collins, CO 80526-3978
Phone (970) 222-8274
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 022801 | Other | ME | ANTHEM MAINE |
| 235380099 | Medicaid | ME | |
| 1283903 | Other | ME | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT1378 | ME | MD | Physical Therapist |
| 9760 | CO | MD | Pediatric Physical Therapist |
| 9273 | MN | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552003200000",
"number": "1659414530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "719 MCGRAW DR",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805263978",
"telephone_number": "970-222-8274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9220 BASS LAKE RD STE 260",
"city": "NEW HOPE",
"state": "MN",
"postal_code": "554283019",
"telephone_number": "763-533-0363"
}
],
"practiceLocations": [
{
"address_1": "719 McGraw Dr",
"address_purpose": "LOCATION",
"city": "Fort Collins",
"state": "CO",
"postal_code": "805263978",
"country_code": "US",
"telephone_number": "970-222-8274",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TINGUELY",
"first_name": "MARY",
"middle_name": "ANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-14",
"last_updated": "2019-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ME",
"license": "PT1378",
"primary": false
},
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "CO",
"license": "9760",
"primary": false
},
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "MN",
"license": "9273",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM MAINE",
"identifier": "022801",
"state": "ME"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "235380099",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "1283903",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Hope, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.