Active NPI
Patrick Joseph Tarnowski, PT, SCS
- Physical Therapist
- Maple Grove, MN
National Provider Identifier
1811945066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4417
- Practice address
- 9325 Upland LN N
Maple Grove, MN 55369-4200 - Phone
- (763) 315-0466
- NPI assigned
- May 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4417 | MN | Primary |
Addresses
Primary practice location
9325 Upland LN N
Maple Grove, MN 55369-4200
Mailing address
4740 Bassett Creek Dr
Golden Valley, MN 55422-4168
Phone (612) 247-3047
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 947973200 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4417 | MN | MD | Sports Physician Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385424000000",
"number": "1811945066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4740 BASSETT CREEK DR",
"city": "GOLDEN VALLEY",
"state": "MN",
"postal_code": "554224168",
"telephone_number": "612-247-3047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9325 UPLAND LN N",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553694200",
"telephone_number": "763-315-0466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TARNOWSKI",
"first_name": "PATRICK",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "PT, SCS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-04",
"last_updated": "2013-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "4417",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "947973200",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maple Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.