Individual provider Active NPI

Nathan CHI Yong Tan, M.D.

  • Family Medicine Physician
  • San Jose, Saipan, MP
National Provider Identifier
1023079761
Registry record updated Jun 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0306 Issued in MP
Practice address
Beach Road, Oleai Business Center
Suite 108-112
San Jose, Saipan, MP 96950
Phone
(670) 235-0994
Fax
(670) 234-3742
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0306 MP Primary

Addresses

Primary practice location

Beach Road, Oleai Business Center
Suite 108-112
San Jose, Saipan, MP 96950

Mailing address

PO Box 500118
Saipan, MP 96950-0118
Phone (670) 235-0994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, MP2 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
I20040315000549 HI Practitioner - Family Practice 5597654756 Reassigns benefits to 2 organizations
I20221121001622 MP Practitioner - Family Practice 5597654756 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0306MPMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kokua Kalihi Valley Comprehensive Family Services CurrentSince Jul 18, 2012 Accepting new patients
Kokua Kalihi Valley Comprehensive Family Services CurrentSince Jul 18, 2012 Accepting new patients
Medical Associates of the Pacific LLC CurrentSince May 1, 2012 Accepting new patients
Kokua Kalihi Valley Comprehensive Family Services Past Accepting new patients

Locations

2239 N School St
Honolulu, HI 96819
Phone (808) 791-9400

2229 N School St
Honolulu, HI 96819
Phone (808) 791-9400

Organizations & group practices 4

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244419200000",
    "number": "1023079761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 500118",
            "city": "SAIPAN",
            "state": "MP",
            "postal_code": "969500118",
            "telephone_number": "670-235-0994",
            "fax_number": "670-234-3742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BEACH ROAD, OLEAI BUSINESS CENTER",
            "address_2": "SUITE 108-112",
            "city": "SAN JOSE, SAIPAN",
            "state": "MP",
            "postal_code": "96950",
            "telephone_number": "670-235-0994",
            "fax_number": "670-234-3742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "NATHAN",
        "middle_name": "CHI YONG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2009-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MP",
            "license": "0306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, Saipan, MP

Sources for this page

Verify at the official NPI Registry.