Dr Tara Vonne Brodersen, DDS in Saint Paul, MN

Dr Tara Vonne Brodersen, DDS is a medicare enrolled "Dentist - General Practice" provider in Saint Paul, Minnesota. Her current practice location is 200 University Ave E, Saint Paul, Minnesota. You can reach out to her office (for appointments etc.) via phone at (651) 291-2848.

Dr Tara Vonne Brodersen is licensed to practice in Minnesota (license number D11913) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1336138882.

Contact Information

	Dr Tara Vonne Brodersen, DDS
	200 University Ave E, Saint Paul, MN 55101-2507
	(651) 291-2848
	(651) 602-6885

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Tara Vonne Brodersen
Gender	Female
Speciality	Dentist - General Practice
Location	200 University Ave E, Saint Paul, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1336138882
Provider Enumeration Date: 10/18/2005
Last Update Date: 03/08/2019

Medicare PECOS Information:

PECOS PAC ID: 3274825542
Enrollment ID: I20190215001839

Medical Identifiers

Medical identifiers for Dr Tara Vonne Brodersen such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1336138882	NPI	-	NPPES
H400538336	Other	MN	MEDICARE UPIN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223G0001X	Dentist - General Practice	D11913 (Minnesota)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Tara Vonne Brodersen allows following entities to bill medicare on her behalf.

Entity Name	Gillette Childrens Specialty Healthcare
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1225119175 PECOS PAC ID: 0547169211 Enrollment ID: O20040503000485

Entity Name	Peterson Dental Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1669046199 PECOS PAC ID: 5890196059 Enrollment ID: O20210624002625

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Tara Vonne Brodersen is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Tara Vonne Brodersen, DDS 200 University Ave E, Saint Paul, MN 55101-2507 Ph: (651) 291-2848	Dr Tara Vonne Brodersen, DDS 200 University Ave E, Saint Paul, MN 55101-2507 Ph: (651) 291-2848

Reviews and Comments

Dentist in Saint Paul, MN

Dr. Julie C Haman, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1514 White Bear Ave N, Saint Paul, MN 55106 Phone: 651-774-0311 Fax: 651-776-3286
Dr. Charles H. Mendes, Dentist Medicare: Medicare Enrolled Practice Location: 550 Snelling Ave S, Saint Paul, MN 55116 Phone: 651-699-0404 Fax: 651-699-9034
Joseph Paul Trowbridge, DDS Dentist Medicare: Medicare Enrolled Practice Location: 30 7th St E, Suite101, Saint Paul, MN 55101 Phone: 651-227-6646 Fax: 651-227-6523
Dr. Minerva C Park, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 555 Wabasha St N Ste 250, Saint Paul, MN 55102 Phone: 651-292-9331
Dr. Jake Samuel Kalkstein, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 450 Syndicate St N Ste 300, Saint Paul, MN 55104 Phone: 651-254-7373
Munira Yusuf, Dentist Medicare: Not Enrolled in Medicare Practice Location: 450 Syndicate St N Ste 300, Saint Paul, MN 55104 Phone: 651-254-7373
Freeman Newton Rosenblum, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 411 Main St, Suite 400, Saint Paul, MN 55102 Phone: 651-224-4969 Fax: 651-223-8047

Dr Tara Vonne Brodersen, DDS - Medicare Dentist in Saint Paul, MN