Tore Detlie, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

29546 Issued in MN

Practice address

918 Demont Ave E
Maplewood, MN 55109-1953

Phone

(952) 595-1100

Fax

(612) 294-4903

NPI assigned

May 11, 2006

Last updated

Jul 19, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, FL, IN3 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 3

Specialty

Diagnostic Radiology

Education

University of Minnesota Medical School, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Scanning Consultants PAGroup PAC ID 9032005376, shared by 5 NPIs, 82 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Medical Scanning Consultants PA

  dba RAYUS Radiology

  • Diagnostic Radiology Physician
  • St Louis Park, MN
  • NPI 1659348092
  Medicare reassignment NPD
• Medical Scanning Consultants PA

  dba Rayus Radiology

  • Diagnostic Radiology Physician
  • Carmel, IN
  • NPI 1396712725
  Medicare reassignment NPD
• Medical Scanning Consultants PA

  dba Rayus Radiology

  • Diagnostic Radiology Physician
  • Oviedo, FL
  • NPI 1871560201
  Medicare reassignment NPD
• Cdi Twin Cities ASC LLC

  dba Rayus Twin Cities ASC

  • Ambulatory Surgical Clinic/Center
  • St Louis Park, MN
  • NPI 1245207687
  NPD
• Medical Scanning Consultants, P.a.

  dba Rayus Radiology

  • Diagnostic Radiology Physician
  • Bloomington, IN
  • NPI 1093166274
  NPD
• Pottstown Clinic Company LLC

  dba Emergency Medicine Pottstown Tower Health Medical Group

  • Family Medicine Physician
  • Pottstown, PA
  • NPI 1649341934

  Diagnostic Radiology

  NPD
• Suburban Radiologic Consultants, LTD.

  • Radiology Clinic/Center
  • Roseville, MN
  • NPI 1629027594
  NPD (past)
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)
• SMH Radiology Associates PA

  • Diagnostic Radiology Physician
  • Sarasota, FL
  • NPI 1356323331
  NPD (past)

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1841240686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN",
            "address_2": "SUITE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445347",
            "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": "918 DEMONT AVE E",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091953",
            "telephone_number": "952-595-1100",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETLIE",
        "first_name": "TORE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "29546",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NH",
            "license": "15435",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Inga Dembinskaite, M.D.
• Kevin Lee Denis, DDS, MS
• Coolidge E Dennis Jr., MA
• Dependable Angels Home Care
• Karin E Detienne
• Ilitch Diaz Gutierrez, M.D.
• Michelle R. Didio, RD
• Danny Diep
• Breanne Dietz, PHARM. D
• Alejandro Diez Freire

• Diagnostic Radiology Physician in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Diagnostic Radiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.