MR. JOHN PAUL TENNIS (PA-C) – Physician Assistant, NPI 1376667063
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
10,570 PHYSICIAN ASSISTANT in CA
Provider Addresses for MR. JOHN PAUL TENNIS (PA-C)
10210 WATERIDGE CIR
UNIT UNIT 164
SAN DIEGO, CA 921215751
Phone: (858) 829-7102
Type: Mailing
34800 BOB WILSON DR
SAN DIEGO, CA 921341098
Phone: (760) 339-2674
Type: Location
34800 Bob Wilson Dr
San Diego, CA 921341098
Phone: (760) 339-2674
Type: Location
3500 Tower Ave
Superior, WI 548804491
Phone: (715) 817-7100
Type: Location
400 E 3RD ST
DULUTH, MN 558051951
Phone: (218) 786-8364
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-05-31
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20221004001983 | I | Physician Assistant | CA | TBD |
| I20240425002857 | I | Physician Assistant | MN | TBD |
| I20240531002526 | I | Physician Assistant | WI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 92121)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | MT | |
| - | ND | |
| Physician Assistant | MN | |
| Nurse Practitioner | SD | |
| - | MN | |
| Qualified Audiologist | MN | |
| - | MN | |
| - | MN | |
| P A T H O L O G Y | WV | |
| Family Practice | MN |
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