Active NPI
Malcolm Zhorg Shan Tan, MD
- Family Medicine Physician
- Concord, NH
National Provider Identifier
1073009072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- RT-3306
- Practice address
- 250 Pleasant St
Concord, NH 03301-2598 - Phone
- (603) 228-7000
- Fax
- (603) 228-7307
- NPI assigned
- Jul 3, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | RT-3306 | NH | Primary |
Addresses
Primary practice location
250 Pleasant St
Concord, NH 03301-2598
Mailing address
250 Pleasant St
Concord, NH 03301-2598
Phone (603) 228-7000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH
- 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 |
|---|---|---|---|---|
| I20180919003140 | NH | Order and Referring Only - Family Practice | 2264783992 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RT-3306 | NH | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530576000000",
"number": "1073009072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 PLEASANT ST",
"city": "CONCORD",
"state": "NH",
"postal_code": "033012598",
"telephone_number": "603-228-7000",
"fax_number": "603-228-7307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 PLEASANT ST",
"city": "CONCORD",
"state": "NH",
"postal_code": "033012598",
"telephone_number": "603-228-7000",
"fax_number": "603-228-7307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAN",
"first_name": "MALCOLM",
"middle_name": "ZHORG SHAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-03",
"last_updated": "2018-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NH",
"license": "RT-3306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; 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.