Individual provider Active NPI

Khoon-Yen Tay, M.D.

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Philadelphia, PA
National Provider Identifier
1013114073
Registry record updated Nov 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
License
MD434680 Issued in PA
Practice address
3401 Civic Center Blvd
Children'S Hospital of Philadelphia - Emergency Med
Philadelphia, PA 19104-4319
Phone
(215) 590-1944
Fax
(215) 590-4454
NPI assigned
Jul 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X MD434680 PA Primary

Addresses

Primary practice location

3401 Civic Center Blvd
Children'S Hospital of Philadelphia - Emergency Med
Philadelphia, PA 19104-4319

Mailing address

100 E Penn SQ
9TH Floor
Philadelphia, PA 19107-3323
Phone (267) 425-9232

Other identifiers 1

IdentifierTypeStateIssuer
1027410950001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120817000214 PA Practitioner - Emergency Medicine 2365610011 Reassigns benefits to 1 organization
I20130124000016 NJ Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 2365610011 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD434680PAMDPediatric Emergency Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Associates, Inc Current Accepting new patients
Children'S Healthcare Associates of New Jersey PC CurrentSince Dec 18, 2012 Accepting new patients
Childrens Health Care Associates of New Jersey PC Current Accepting new patients
Childens Health Care Associates of New Jersey PC CurrentSince Dec 18, 2012 Accepting new patients
Childrens Health Care Associates, Inc CurrentSince Nov 18, 2018 Accepting new patients

Locations

707 Alexander Rd
Princeton, NJ 08540
Phone (609) 520-1717

100 Bowman Dr
Voorhees, NJ 08043
Phone (856) 247-3000

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232

100 N 20th St
Ste 301
Philadelphia, PA 19103
Phone (215) 561-0959

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543536000000",
    "number": "1013114073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E PENN SQ",
            "address_2": "9TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073323",
            "telephone_number": "267-425-9232",
            "fax_number": "267-425-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "CHILDREN'S HOSPITAL OF PHILADELPHIA - EMERGENCY MED",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-1944",
            "fax_number": "215-590-4454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAY",
        "first_name": "KHOON-YEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2018-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "PA",
            "license": "MD434680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027410950001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.