Jenna Leigh Tate, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

60599 Issued in MN

Practice address

14050 Nicollet Ave
Suite 300
Burnsville, MN 55337-5710

Phone

(952) 435-2450

Fax

(952) 892-0217

NPI assigned

Jun 1, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jenna Leigh Martens Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Metropolitan Pediatric Specialists, P.a.

  • Clinic/Center
  • Edina, MN
  • NPI 1558459206
  NPD (past)

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

{
    "created_epoch": "1370044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467072000000",
    "number": "1881031706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14829 MARYLAND AVE",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553783637",
            "telephone_number": "952-457-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14050 NICOLLET AVE",
            "address_2": "SUITE 300",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553375710",
            "telephone_number": "952-435-2450",
            "fax_number": "952-892-0217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "JENNA",
        "middle_name": "LEIGH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-01",
        "last_updated": "2016-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "R9745",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "60599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "MARTENS",
            "middle_name": "LEIGH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Madilyn Taleen
• Jens Prem Tamang, OTR
• Marinel Tansia
• Olga Lidia Tapia-Farrell, LMFT
• Corinne J Tate, PT
• Alexis Kaelin Taylor, LICSW
• Camesheia Taylor
• Christine Marie Taylor, PT
• Linsey Taylor
• Tayo Skilled Services, Inc.

• Pediatrics Physician in Burnsville, MN
• Providers in Burnsville, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.