TANNER STIPPICH – Physician Assistant, NPI 1053924415
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,499 PHYSICIAN ASSISTANT in IN
Provider Addresses for TANNER STIPPICH
801 MEDICAL DR STE A
LIMA, OH 458044030
Phone: (192) 226-6224
Fax: (419) 224-0015
Type: Mailing
1819 CAREW ST
FORT WAYNE, IN 468054705
Phone: (260) 702-8064
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $64.
Total Amount is formed as General ($64) + Research ($0) + Ownership ($0) = $64.
Last reported payment date: 2024-11-20 • Largest payer in this snapshot: Stryker Corporation ($45).
Total Amount
$64
General + Research + Ownership
Payments
2
Total payment records
General Amount
$64
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Stryker Corporation | $45 |
| SANOFI-AVENTIS U.S. LLC | $19 |
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: 2022-02-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20220221002149 | I | Physician Assistant | OH | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 179 | 148 | $0 |
| 73030 | X-ray of shoulder, minimum of 2 views | 176 | 103 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 50 | 47 | $0 |
| 73140 | X-ray of finger, minimum of 2 views | 43 | 28 | $0 |
| 73110 | X-ray of wrist, minimum of 3 views | 41 | 23 | $0 |
Insurance plans in this area (ZIP 45804)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | OH | |
| Pain Management | OH | |
| - | OH | |
| Physician Assistant | OH | |
| Physician Assistant | OH | |
| Physician Assistant | OH | |
| Orthopedic Surgery | OH | |
| Nurse Practitioner | OH | |
| Physician Assistant | OH | |
| Physician Assistant | OH |
Reviews
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