NPIMap

Individual provider Active NPI

Mina F Tanaka, MD

  • Internal Medicine Physician
  • Shiprock, NM
National Provider Identifier
1740661248
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R8496 Issued in TX
Practice address
US Hwy 491 North
Shiprock, NM 87420
Phone
(505) 368-6001
Fax
(505) 368-7011
NPI assigned
Jun 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R8496 TX Primary

Addresses

Primary practice location

US Hwy 491 North
Shiprock, NM 87420

Mailing address

PO Box 160
Shiprock, NM 87420-0160
Phone (505) 368-6001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210301001245 TX Practitioner - Internal Medicine 3072821198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DHHS PHS Naihs Shiprock HospitalGroup PAC ID 0749193837, 148 clinicians

Practice addresses (Care Compare)

Highway 491
Shiprock, NM 87420-0160
Phone 50536860016401

P O Box
160 Attn Business Office
Shiprock, NM 87420-0160

PO Box
Suite 160
Shiprock, NM 87420-0160

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.26 of 100Reported as group
Quality
74.27
Improvement activities
40
Cost
78.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R8496TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Nov 19, 2020 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Nov 19, 2020 Accepting new patients

Organizations & group practices 2

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 7

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": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1740661248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "874200160",
            "telephone_number": "505-368-6001",
            "fax_number": "505-368-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US HWY 491 NORTH",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "87420",
            "telephone_number": "505-368-6001",
            "fax_number": "505-368-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANAKA",
        "first_name": "MINA",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2021-03-04",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "R8496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shiprock, NM

Sources for this page

Verify at the official NPI Registry.