Individual provider Active NPI

Smyrna Tuburan, MD

  • Pediatric Radiology Physician
  • Minneapolis, MN
National Provider Identifier
1679725261
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
78493 Issued in MN
Practice address
2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone
(952) 992-5398
NPI assigned
Oct 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X 78493 GA
Pediatric Radiology Physician 2085P0229X 78493 MN Primary

Addresses

Primary practice location

2525 Chicago Ave
Minneapolis, MN 55404-4518

Mailing address

2525 Chicago Ave
Minneapolis, MN 55404-4518

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address choa@choa.gadirect.net
CONNECT URL www.childrensmn.org

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
I20250424002635 MN Practitioner - Diagnostic Radiology 4183848609 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Loma Linda University School of Medicine, 2008
Medicare assignment
May accept Medicare assignment
Group practices
Children'S Health CareGroup PAC ID 2668370966, 76 clinicians

Practice addresses (Care Compare)

2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone (612) 813-6273

345 N Smith Ave
Saint Paul, MN 55102-2346
Phone (651) 220-6000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
78493GAMDPediatric Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care CurrentSince Feb 16, 2025 Accepting new patients
Childrens Health Care CurrentSince Feb 16, 2025 Accepting new patients
Childrens Health Care Current Accepting new patients

Locations

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691

Organizations & group practices 3

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": "1224028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1679725261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044518",
            "telephone_number": "952-992-5398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUBURAN",
        "first_name": "SMYRNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-15",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "GA",
            "license": "78493",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "MN",
            "license": "78493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "1405 Clifton Rd NE",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303221060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.childrensmn.org",
            "affiliation": "N",
            "address_1": "2525 Chicago Ave",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554044518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.