Active NPI
Romeo Bihag Tan, MD
- Surgery Physician
- Moundsville, WV
National Provider Identifier
1053307520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 10494
- Practice address
- 1601 3Rd St
Moundsville, WV 26041-1716 - Phone
- (304) 845-2330
- Fax
- (304) 845-2397
- NPI assigned
- Sep 21, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 10494 | WV | |
| Surgery Physician | 208600000X | 10494 | WV | Primary |
Addresses
Primary practice location
1601 3Rd St
Moundsville, WV 26041-1716
Mailing address
1601 3Rd St
Moundsville, WV 26041-1716
Phone (304) 845-2330
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10494 | Other | WA | HMO |
| 0128037000 | Medicaid | WV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101118000910 | WV | Practitioner - Family Practice | 4385830165 | Practice locations: Glen Dale, WV; Moundsville, WV |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261008000000",
"number": "1053307520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 3RD ST",
"city": "MOUNDSVILLE",
"state": "WV",
"postal_code": "260411716",
"telephone_number": "304-845-2330",
"fax_number": "304-845-2397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 3RD ST",
"city": "MOUNDSVILLE",
"state": "WV",
"postal_code": "260411716",
"telephone_number": "304-845-2330",
"fax_number": "304-845-2397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAN",
"first_name": "ROMEO",
"middle_name": "BIHAG",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-21",
"last_updated": "2009-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WV",
"license": "10494",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WV",
"license": "10494",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMO",
"identifier": "10494",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0128037000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Moundsville, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.