NPIMap

Individual provider Active NPI

Annie Tan, MD

  • Gynecologic Oncology Physician
  • Coon Rapids, MN
National Provider Identifier
1750470696
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
47116 Issued in MN
Practice address
11850 Blackfoot St NW
Suite 100
Coon Rapids, MN 55433-2598
Phone
(763) 721-2100
Fax
(763) 721-2190
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X 47116 MN Primary

Addresses

Primary practice location

11850 Blackfoot St NW
Suite 100
Coon Rapids, MN 55433-2598

Mailing address

11850 Blackfoot St NW
Suite 100
Coon Rapids, MN 55433-2598
Phone (763) 721-2100

Other identifiers 7

IdentifierTypeStateIssuer
07-05956OtherMNMEDICA
2368961OtherMNARAZ
HP53303OtherMNHEALTHPARTNERS
961141050294OtherMNPREFERREDONE
132945OtherMNUCARE
83694-0OtherMNFAIRVIEW
815T5TAOtherMNBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20081029000913 MN Practitioner - Gynecological Oncology 7911066311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gynecological Oncology
Education
University of Minnesota Medical School, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Minnesota Oncology Hematology PAGroup PAC ID 6709799752, 131 clinicians

Practice addresses (Care Compare)

11850 Blackfoot St NW
Suite 100
Coon Rapids, MN 55433-2774
Phone (763) 519-7440

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.19 of 100Reported as apm
Quality
72.34
Promoting interoperability
98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus16

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Oncology Hematology PA CurrentSince Sep 8, 2008 Accepting new patients
Minnesota Oncology Hematology, PA Gynecologic Oncology CurrentSince Sep 8, 2008 Accepting new patients
Minnesota Oncology Hematology, PA PastSince Jan 12, 2020 Accepting new patients
Allina Health System Past Accepting new patients
Minnesota Oncology Hematology, PA Gynecologic Oncology Past Accepting new patients

Locations

1175 Paysphere Cir
Chicago, IL 60674

675 E Nicollet Blvd
Ste 100
Burnsville, MN 55337
Phone (952) 435-8516

110105 Pioneer Trl W
Ste 302
Chaska, MN 55318
Phone (952) 361-5800

10150 Niagara Ln N
#100
Maple Grove, MN 55369
Phone (763) 220-1316

6545 France Ave S
Ste 210
Minneapolis, MN 55435
Phone (952) 928-2900

480 Osborne Rd NE
Ste 220
Minneapolis, MN 55432
Phone (763) 786-1620

11850 Blackfoot St NW
Ste 100
Minneapolis, MN 55433
Phone (763) 712-2100

910 E 26th St
Ste 100200
Minneapolis, MN 55404
Phone (612) 884-6300

2805 Campus Dr
Ste 105
Plymouth, MN 55441
Phone (763) 519-7440

2550 University Ave W
Ste 105N
Saint Paul, MN 55114
Phone (651) 602-5335

310 Smith Ave N
Ste 100
Saint Paul, MN 55102
Phone (651) 251-5500

2550 University Ave W
Ste 110N
Saint Paul, MN 55114
Phone (651) 602-5309

1580 Beam Ave
Saint Paul, MN 55109
Phone (651) 255-8480

560 S Maple St
Ste 100
Waconia, MN 55387
Phone (952) 442-6006

6025 Lake Rd
Ste 110
Woodbury, MN 55125
Phone (651) 735-7414

Interoperability endpoints

  • Direct secure messaging: annie.tan@moh.ikm.direct-ci.com
  • Direct secure messaging: atan148591@fairview.direct-ci.com

Organizations & group practices 5

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 36

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 36

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442966400000",
    "number": "1750470696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11850 BLACKFOOT ST NW",
            "address_2": "SUITE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332598",
            "telephone_number": "763-721-2100",
            "fax_number": "763-721-2190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11850 BLACKFOOT ST NW",
            "address_2": "SUITE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332598",
            "telephone_number": "763-721-2100",
            "fax_number": "763-721-2190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "ANNIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2015-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "MN",
            "license": "47116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "07-05956",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ",
            "identifier": "2368961",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP53303",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "961141050294",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "132945",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAIRVIEW",
            "identifier": "83694-0",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "815T5TA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.