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ANGELA M TULLBANE RD, LD
NPI 1689211526
Dietitian, Registered in Plymouth, MN

Active since December 10, 2019Accepts Medicare Assignment
16800 37TH PL N, STE 100, PLYMOUTH, MN 55446(763) 520-7870(763) 520-7580 Get Directions Write a Review

NPPES record last updated: November 9, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 9, 2023, Dec 10, 2019 (2 updates tracked since 2019).

About Angela M Tullbane Rd, Ld NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANGELA M TULLBANE RD, LD (NPI 1689211526) is an individual dietitian, registered in Plymouth, Minnesota, licensed in Minnesota (4035) and active in the NPI registry since December 2019. She is a graduate of Other (2016).

NPPES Registry Identity

NPI1689211526
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameANGELA M TULLBANECredential: RD, LD
Location Address16800 37TH PL N, STE 100Plymouth, MN 55446
Mailing Address4200 Dahlberg Dr Ste 300Golden Valley, MN 55422-4841 · (952) 512-5600
Phone(763) 520-7870
Fax(763) 520-7580
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateDecember 10, 2019
Last NPPES UpdateNovember 9, 20232 updates tracked since enumeration
NPPES CertifiedNovember 8, 2023
✔ NPI 1689211526 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in MN · 4035
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
16800 37TH PL N, Plymouth, MN 55446
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Angela M Tullbane Rd, Ld is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5496105017
PECOS Enrollment IDI20240122004021

Medicare Billing Reassignment

Medicare enrollment records show Angela Tullbane reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Infinite Health Collaborative, PA
15 mi
Orthopaedic Surgery
3500 AMERICAN BLVD W STE 300
Bloomington, MN 55431
  • Reassigned Medicare billing, Minnesota enrollment
  • 728 clinicians in this Medicare group
NPI 1164474250 (952) 512-5600

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55446 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $56.00 – $168.28
Typical copayment $0.00 (range $14.00 – $42.07)
Most-billed visit code NA
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARLA N KINNUNEN DPT
Physical Therapist
16800 37TH PL N, STE 100
PLYMOUTH, MN 55446
Hennepin County (763) 520-7870
MR. LUCAS CHARLES GLYNN PA-C
Physician Assistant
16800 37TH PL N, STE 200
PLLYMOUTH, MN 55446
Hennepin County (763) 520-7870
THANE DAVID WIDMER DPT
Physical Therapist
16800 37TH PL N, STE 100
PLYMOUTH, MN 55446
Hennepin County (763) 520-7870

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Angela Tullbane's NPI number?

The NPI number for Angela Tullbane is 1689211526. It was assigned to this individual provider in the NPPES registry on December 10, 2019.

Where is Angela Tullbane located?

Angela Tullbane practices at 16800 37th Pl N Ste 100, Plymouth, MN 55446. The listed phone number is (763) 520-7870.

What is Angela Tullbane's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Angela Tullbane enrolled in Medicare?

Yes. Angela Tullbane is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Angela Tullbane's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Angela Tullbane reassigns Medicare benefits to Infinite Health Collaborative, PA (Bloomington, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Angela Tullbane's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Angela Tullbane was last updated on November 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.