Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tanner Jesus Verduzco

Individual provider Physician Assistant · NPI 1073276259

Tanner Jesus Verduzco is a Physician Assistant in Maple Grove, Minnesota. Qualified in 2022, 4 years ago. Practices with Andrew J Will MD PA, a 36-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth.

Years since qualifying
4
In the registry since
2021
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Practice location Address checks out

12000 Elm Creek Blvd N Ste 300
Maple Grove, MN 55369-7075
Phone: (952) 841-2345
Fax: (952) 841-2346
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 7235 Ohms Ln, Edina, MN 55439-2148 — (952) 841-2345

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1073276259
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 14, 2021
Last updated in NPPESDecember 21, 2023
Certification dateDecember 21, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Andrew J Will Md Pa — 36 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Maple Grove