Active NPI
Thomas Charles Tunberg, M.D.
- Surgery Physician
- Fridley, MN
National Provider Identifier
1932211034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 31964
- Practice address
- 6341 University Ave NE
Fridley, MN 55432-4946 - Phone
- (763) 572-5710
- Fax
- (763) 586-5888
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 31964 | MN | Primary |
Addresses
Primary practice location
6341 University Ave NE
Fridley, MN 55432-4946
Mailing address
6401 University Ave NE
Fridley, MN 55432-4341
Phone (763) 572-5710
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0304519 | Other | MN | PREFERRED ONE |
| HP19612 | Other | MN | HEALTHPARTNERS |
| 107439 | Other | MN | UCARE MN |
| 1712216 | Other | MN | MEDICA |
| 74D20TU | Other | MN | BCBS OF MN |
| 25199 | Other | MN | AMERICA'S PPO |
| 4059827 | Other | MN | AETNA INS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31964 | MN | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Columbia Park Medical Group, PA | Surgery | Past | Accepting new patients |
Organizations & group practices 1
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": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1932211034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6401 UNIVERSITY AVE NE",
"city": "FRIDLEY",
"state": "MN",
"postal_code": "554324341",
"telephone_number": "763-572-5710",
"fax_number": "763-571-3008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6341 UNIVERSITY AVE NE",
"city": "FRIDLEY",
"state": "MN",
"postal_code": "554324946",
"telephone_number": "763-572-5710",
"fax_number": "763-586-5888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUNBERG",
"first_name": "THOMAS",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MN",
"license": "31964",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "0304519",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP19612",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE MN",
"identifier": "107439",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "1712216",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MN",
"identifier": "74D20TU",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICA'S PPO",
"identifier": "25199",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA INS",
"identifier": "4059827",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fridley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.