Individual provider Active NPI

John Clinton Tanner III, M.D.

  • Orthopaedic Foot and Ankle Surgery Physician
  • Robbinsdale, MN
National Provider Identifier
1780882662
Registry record updated Aug 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X
License
109070 Issued in MN
Practice address
3366 Oakdale Ave N
Suite 103
Robbinsdale, MN 55422-2948
Phone
(763) 520-7870
Fax
(763) 520-7580
NPI assigned
Jul 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X 4301090393 MI
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X 109070 MN Primary

Addresses

Primary practice location

3366 Oakdale Ave N
Suite 103
Robbinsdale, MN 55422-2948

Mailing address

4200 Dahlberg Dr
Suite 300
Golden Valley, MN 55422-4840
Phone (952) 512-5600

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
I20160809001843 MN Practitioner - Orthopedic Surgery 2062656580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

3366 Oakdale Ave N
Suite 103
Robbinsdale, MN 55422-2961
Phone (763) 520-7870

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301090393MIMDOrthopaedic Foot and Ankle Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA Foot and Ankle Surgery CurrentSince Sep 1, 2016 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Sep 1, 2016 Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients
St. Croix Orthopaedics, PA Past Accepting new patients

Locations

11225 Ulysses St NE
Blaine, MN 55434
Phone (763) 302-2600

5601 96th Ave N
Ste 200
Brooklyn Park, MN 55443
Phone (763) 786-9543

9630 Grove Cir N
Ste 200
Maple Grove, MN 55369
Phone (763) 520-7580

4200 Dahlberg Dr
Ste 300
Minneapolis, MN 55422
Phone (952) 512-5600

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

16800 37th Pl N
#200
Plymouth, MN 55446
Phone (635) 207-8707

3366 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5281

3366 Oakdale Ave N
Ste 103
Robbinsdale, MN 55422

Interoperability endpoints

  • Direct secure messaging: johntanner@tw.allscriptsdirect.net

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.

Hospital & facility affiliations 5

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": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1780882662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 DAHLBERG DR",
            "address_2": "SUITE 300",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224840",
            "telephone_number": "952-512-5600",
            "fax_number": "952-512-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3366 OAKDALE AVE N",
            "address_2": "SUITE 103",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222948",
            "telephone_number": "763-520-7870",
            "fax_number": "763-520-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "JOHN",
        "middle_name": "CLINTON",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "MI",
            "license": "4301090393",
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "MN",
            "license": "109070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Robbinsdale, MN

Sources for this page

Verify at the official NPI Registry.