Individual provider Active NPI

Romie Andrea Mendoza Tinsay, MD, FAAP

  • Pediatrics Physician
  • Bemidji, MN
National Provider Identifier
1750312708
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
42461 Issued in MN
Practice address
1300 Anne St NW
Bemidji, MN 56601-5103
Phone
(218) 333-5000
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 42461 MN Primary

Addresses

Primary practice location

1300 Anne St NW
Bemidji, MN 56601-5103

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

Other practice location 1

Highway 1 Red Lake Hospital
Red Lake, MN 56671-0497
Phone (218) 679-3912

Other identifiers 1

IdentifierTypeStateIssuer
476753500MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, TX2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20131024000122 MN Practitioner - Pediatric Medicine 7517192719 Reassigns benefits to 1 organization
I20171004002056 TX Practitioner - Pediatric Medicine 7517192719 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42461MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PHS Indian Hospital CurrentSince Sep 19, 2017 Accepting new patients
Sanford Health of Northern Minnesota CurrentSince Jul 31, 2014 Accepting new patients
Sanford Health of Northern Minnesota Current Accepting new patients
Sanford Health of Northern Minnesota CurrentSince Jul 31, 2014 Accepting new patients

Locations

1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020

1300 Anne St NW
Bemidji, MN 56601
Phone (218) 333-5794

4000 28th Ave S
Moorhead, MN 56560
Phone (701) 234-3200

Organizations & group practices 4

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1750312708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 ANNE ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015103",
            "telephone_number": "218-333-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Highway 1 Red Lake Hospital",
            "address_purpose": "LOCATION",
            "city": "Red Lake",
            "state": "MN",
            "postal_code": "566710497",
            "country_code": "US",
            "telephone_number": "218-679-3912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TINSAY",
        "first_name": "ROMIE ANDREA",
        "middle_name": "MENDOZA",
        "name_prefix": "Dr.",
        "credential": "MD, FAAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "42461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "476753500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bemidji, MN

Sources for this page

Verify at the official NPI Registry.