NPIMap

Individual provider Active NPI

Reynaldo Go Tan, M.D.

  • Nephrology Physician
  • Brooklyn, NY
National Provider Identifier
1053343731
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
202867 Issued in NY
Practice address
8122 7TH Ave
Brooklyn, NY 11228-2805
Phone
(718) 836-0225
Fax
(718) 836-0114
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 202867 NY
Nephrology Physician 207RN0300X 202867 NY Primary

Addresses

Primary practice location

8122 7TH Ave
Brooklyn, NY 11228-2805

Mailing address

8122 7TH Ave
Brooklyn, NY 11228-2805
Phone (718) 836-0225

Other identifiers 1

IdentifierTypeStateIssuer
01609067MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070329000163 NY Practitioner - NephrologyPractitioner - Internal Medicine 3173627247 Reassigns benefits to 1 organization
Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8122 7TH Ave
Brooklyn, NY 11228-2805
Phone (718) 836-0225

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202867NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Nephrology PLLC Nephrology CurrentSince May 9, 2007 Accepting new patients
Maimonides Medical Center Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Narrows Nephrology Nephrology Past Accepting new patients

Locations

8122 7th Ave
Brooklyn, NY 11228
Phone (718) 331-3140

491 Bard Ave
Staten Island, NY 10310
Phone (718) 442-1312

800 Castleton Ave
Ste H
Staten Island, NY 10310

800 Castleton Ave
Staten Island, NY 10310
Phone (718) 354-3344

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: rtan@1828.mdlanddirect.com
  • Direct secure messaging: reynaldotan@mai.allscriptsdirect.net
  • Direct secure messaging: rgt9002@direct.nyp.org

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1053343731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8122 7TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112282805",
            "telephone_number": "718-836-0225",
            "fax_number": "718-836-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8122 7TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112282805",
            "telephone_number": "718-836-0225",
            "fax_number": "718-836-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "REYNALDO",
        "middle_name": "GO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "202867",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "202867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01609067",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.