NPIMap

Organization Active NPI

The Ear, Nose and Throat Clinic and Hearing Center, P.a.

  • Otolaryngology Physician
  • Edina, MN
National Provider Identifier
1881708030
Registry record updated Feb 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
30533 Issued in MN
Legal business name
THE EAR, NOSE AND THROAT CLINIC AND HEARING CENTER, P.A.
Practice address
7300 France Ave S Ste 420
Edina, MN 55435-4504
Phone
(952) 832-5252
NPI assigned
Aug 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2016

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

Authorized official

Name
Thomas Michael Tedford, MDNPI 1801804489
Title
President
Phone
(952) 832-5252

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 30533 MN Primary

Addresses

Primary practice location

7300 France Ave S Ste 420
Edina, MN 55435-4504

Mailing address

7300 France Ave S Ste 420
Edina, MN 55435-4504
Phone (952) 832-5252

Other identifiers 6

IdentifierTypeStateIssuer
60868OtherPREFERRED ONE
656058000MedicaidMN
150566OtherUCARE
DE8379OtherRAILROAD MEDICARE
32G94EAOtherBLUE CROSS BLUE SHIELD
C02994OtherMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060928000219 MN Part B Supplier - Clinic/Group Practice 3072518992 Receives reassigned benefits from 16 practitioners
Practice locations: Edina, MN

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

7300 France Ave S
Ste 410
Edina, MN 55435
Phone (952) 227-3639

7400 France Ave S
Ste 107
Minneapolis, MN 55435
Phone (952) 832-5252

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455753600000",
    "number": "1881708030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 FRANCE AVE S STE 420",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354504",
            "telephone_number": "952-832-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 FRANCE AVE S STE 420",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354504",
            "telephone_number": "952-832-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EAR, NOSE AND THROAT CLINIC AND HEARING CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2016-02-18",
        "status": "A",
        "authorized_official_last_name": "TEDFORD",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-832-5252",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "MN",
            "license": "30533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "60868",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "656058000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "150566",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE8379",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "32G94EA",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "C02994",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.