Individual provider Active NPI

Timothy H Jan, DO

  • Diagnostic Radiology Physician
  • Eden Prairie, MN
National Provider Identifier
1750775755
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
TL.0006273 Issued in CO
Practice address
11995 Singletree LN Ste 500
Eden Prairie, MN 55344-5349
Phone
(952) 595-1301
Fax
(612) 294-4903
NPI assigned
Mar 27, 2015
Last updated
Jan 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 5101025292 MI
Diagnostic Radiology Physician 2085R0202X TL.0006273 CO Primary

Addresses

Primary practice location

11995 Singletree LN Ste 500
Eden Prairie, MN 55344-5349

Mailing address

11995 Singletree LN Ste 500
Eden Prairie, MN 55344-5349
Phone (952) 595-1301

Other practice location 1

4660 S Hagadorn Rd Ste 510
East Lansing, MI 48823-6805
Phone (517) 353-5053

Other practice location 2

4660 S Hagadorn Rd Ste 410
East Lansing, MI 48823-6819
Phone (517) 353-5053

Other practice location 3

3220 Discovery Dr Ste 100
Lansing, MI 48910-8609
Phone (517) 975-8930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CO, ID, WA4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20200617001131 TX Practitioner - Diagnostic Radiology 1153621529 Reassigns benefits to 9 organizations
I20210129000702 CO Practitioner - Diagnostic Radiology 1153621529 Reassigns benefits to 9 organizations
I20220818002831 ID Practitioner - Diagnostic Radiology 1153621529 Reassigns benefits to 1 organization
I20220916000956 WA Practitioner - Diagnostic Radiology 1153621529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Lake Erie Col of Osteo Med at Seton Hill Univ, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evergreen Radia LLCGroup PAC ID 4587568076, 116 clinicians
Swedish Radia Imaging Center at Edmonds LLCGroup PAC ID 5496778292, 115 clinicians
South Sound Radiologists Inc P SGroup PAC ID 1254229305, 76 clinicians
Radia Oregon Radiology Medical Group LLCGroup PAC ID 2961852637, 122 clinicians
Radia California Radiology Medical Group IncGroup PAC ID 8921465998, 134 clinicians
Radia Inc P SGroup PAC ID 9931012812, 275 clinicians
Swedish Health ServicesGroup PAC ID 3173433067, 156 clinicians
Medford Radiological Group PCGroup PAC ID 2062303324, 91 clinicians
Radiology Associates PAGroup PAC ID 7517953912, 103 clinicians

Practice addresses (Care Compare)

Flower Mound, TX 75028
Phone (918) 392-1702

Grapevine, TX 76051
Phone (918) 392-1702

13020 Meridian Ave S
Everett, WA 98208-6468
Phone (425) 357-3960

1560 Yaggi Dr
Flower Mound, TX 75028-3645
Phone (509) 662-1511

1593 E Polston Ave
Post Falls, ID 83854-5326
Phone (208) 262-2300

6431 Freeport Dr
Highlands Ranch, CO 80130-3336
Phone (541) 618-5800

905 S Wiley CT
Superior, CO 80027-8012
Phone (352) 328-7315

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TL.0006273COMDDiagnostic Radiology Physician
5101025292MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radia Oregon Radiology Medical Group LLC Diagnostic Radiology CurrentSince Jan 1, 2024 Accepting new patients
Swedish Health Services CurrentSince Sep 2, 2022 Accepting new patients
Swedish Radia Imaging Center at Edmonds LLC Diagnostic Radiology CurrentSince Jan 1, 2025 Accepting new patients
Radiology Associates PA Diagnostic Radiology CurrentSince Nov 1, 2022 Accepting new patients
Medford Radiological Group, PC Diagnostic Radiology CurrentSince Jun 1, 2022 Accepting new patients
The Unity Hospital of Rochester CurrentSince May 1, 2021 Accepting new patients
Swedish Health Services CurrentSince Sep 2, 2022 Accepting new patients
Singleton Associates PA Diagnostic Radiology CurrentSince Feb 1, 2022 Accepting new patients
Radia Imaging Center Holdings LLC Diagnostic Radiology CurrentSince Jan 20, 2025 Accepting new patients
Wenatchee Valley Hospital CurrentSince Jul 1, 2022 Accepting new patients
Radia California Radiology Medical Group Inc Diagnostic Radiology CurrentSince Jan 1, 2025 Accepting new patients
Central Washington Health Services Association CurrentSince Feb 1, 2023 Accepting new patients
Red River Consultants, Inc Diagnostic Radiology CurrentSince Jul 1, 2021 Accepting new patients
South Sound Radiologists Inc P S Diagnostic Radiology CurrentSince Jan 1, 2025 Accepting new patients
Evergreen Radia LLC Diagnostic Radiology CurrentSince Jan 1, 2025 Accepting new patients
Radia Inc P S Diagnostic Radiology CurrentSince Aug 17, 2022 Accepting new patients
Public Hospital District No 4, King County Wa Past Accepting new patients
Synergy Radiology Associates PastSince Jun 11, 2023 Accepting new patients
Msu Health Care Inc. Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

500 S University Ave
Ste 101
Little Rock, AR 72205
Phone (501) 686-2688

400 N McDowell Blvd
Petaluma, CA 94954
Phone (707) 778-1111

19950 Rinaldi St
Ste 101B
Porter Ranch, CA 91326
Phone (818) 496-7517

1450 Medical Center Dr
Rohnert Park, CA 94928
Phone (707) 546-3210

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

26357 McBean Pkwy
Ste 155
Santa Clarita, CA 91355
Phone (661) 288-5940

1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300

121 Sotoyome St
Santa Rosa, CA 95405
Phone (707) 546-3141

925 Corporate Cntr Pkwy
Ste A
Santa Rosa, CA 95407
Phone (707) 543-2000

6580 Hembree Ln
Ste 270
Windsor, CA 95492
Phone (707) 838-2044

1593 E Polston Ave
Post Falls, ID 83854
Phone (208) 262-2300

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

19020 33rd Ave W
Ste 210
Lynnwood, WA 98036
Phone 42556315001

18100 NE Union Hill Rd
Redmond, WA 98052
Phone (425) 455-3600

820 N Chelan Ave
Wenatchee, WA 98801
Phone (509) 863-4868

Interoperability endpoints

  • Direct secure messaging: tjan561777@direct.peacehealth.org

Organizations & group practices 21

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 21

Hospital & facility affiliations 8

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": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1750775755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445349",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445349",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4660 S Hagadorn Rd Ste 510",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488236805",
            "country_code": "US",
            "telephone_number": "517-353-5053",
            "fax_number": "517-884-7640",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4660 S Hagadorn Rd Ste 410",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488236819",
            "country_code": "US",
            "telephone_number": "517-353-5053",
            "fax_number": "517-884-7640",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3220 Discovery Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489108609",
            "country_code": "US",
            "telephone_number": "517-975-8930",
            "fax_number": "517-337-4985",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAN",
        "first_name": "TIMOTHY",
        "middle_name": "H",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-27",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "5101025292",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "TL.0006273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

Verify at the official NPI Registry.