NPIMap

Individual provider Active NPI

Tanner Calvin Harrah, D.O.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • San Dimas, CA
National Provider Identifier
1992169437
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
20A15819 Issued in CA
Practice address
1334 W Covina Blvd Ste 105
San Dimas, CA 91773-3211
Phone
(909) 599-0881
NPI assigned
Apr 11, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XX0005X 20A15819 CA Primary

Addresses

Primary practice location

1334 W Covina Blvd Ste 105
San Dimas, CA 91773-3211

Mailing address

1334 W Covina Blvd Ste 105
San Dimas, CA 91773-3211
Phone (909) 599-0881

Other practice location 1

1400 NW 12th Ave
Miami, FL 33136-1003
Phone (305) 689-5910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210416001760 CA Practitioner - Orthopedic Surgery 8628486388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
West Virginia School of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Orthopedic Associates Medical Group IncGroup PAC ID 2961452032, 4 clinicians

Practice addresses (Care Compare)

627 E Foothill Blvd
San Dimas, CA 91773-1208
Phone (909) 599-0881

Hospital & facility affiliations

  • Sure Care Health Care Services Home health agency, Covina, CA, CCN 557755
  • San Dimas Community Hospital Hospital, San Dimas, CA, CCN 050588
  • Casa Colina Hospital Hospital, Pomona, CA, CCN 050782
  • Emanate Health Inter-Community Hospital Hospital, Covina, CA, CCN 050382
  • Montclair Hospital Medical Center Hospital, Montclair, CA, CCN 050758
  • Chino Valley Medical Center Hospital, Chino, CA, CCN 050586

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement22
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)12
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
15819CAMDChiropractor
20A15819CAMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients
Joon Y Choi MD Inc Single Specialty PastSince Aug 13, 2023 Accepting new patients
San Dimas Community Hospital, Inc. Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: casacolina@direct.casacolina.org

Organizations & group practices 4

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1992169437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1334 W COVINA BLVD STE 105",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733211",
            "telephone_number": "909-599-0881",
            "fax_number": "909-394-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1334 W COVINA BLVD STE 105",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733211",
            "telephone_number": "909-599-0881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 NW 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361003",
            "country_code": "US",
            "telephone_number": "305-689-5910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRAH",
        "first_name": "TANNER",
        "middle_name": "CALVIN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-11",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "20A15819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

Verify at the official NPI Registry.