Individual provider Active NPI

Jonathan C. Tallman, M.D.

  • Family Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1861467227
Registry record updated Jun 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
38349 Issued in MN
Practice address
5700 Bottineau Blvd
Suite 100
Minneapolis, MN 55429-3183
Phone
(763) 504-6500
Fax
(763) 537-1972
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 38349 MN Primary

Addresses

Primary practice location

5700 Bottineau Blvd
Suite 100
Minneapolis, MN 55429-3183

Mailing address

5700 Bottineau Blvd
Suite 100
Minneapolis, MN 55429-3183
Phone (763) 504-6500

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
I20051012000020 MN Practitioner - Family Practice 8820013519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Family Physicians PAGroup PAC ID 0042102956, 26 clinicians

Practice addresses (Care Compare)

1495 County Rd 101
Plymouth, MN 55447-3078
Phone (763) 504-6500

5700 Bottineau Blvd
Suite 100
Crystal, MN 55429-3184
Phone (763) 504-6500

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy12
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
38349MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Physicians Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jonathantallman@northwestf.allscriptsdirect.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340841600000",
    "number": "1861467227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 BOTTINEAU BLVD",
            "address_2": "SUITE 100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554293183",
            "telephone_number": "763-504-6500",
            "fax_number": "763-537-1972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 BOTTINEAU BLVD",
            "address_2": "SUITE 100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554293183",
            "telephone_number": "763-504-6500",
            "fax_number": "763-537-1972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLMAN",
        "first_name": "JONATHAN",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2012-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "38349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.