Edwin C Tan, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

132804 Issued in NY

Practice address

13626 37TH Ave
Flushing, NY 11354-6533

Phone

(718) 886-1200

Fax

(718) 886-3901

NPI assigned

Aug 29, 2005

Last updated

Jul 2, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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

• Charles B. Wang Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • New York, NY
  • NPI 1144203498
  NPD (past)
• Charles B. Wang Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Flushing, NY
  • NPI 1780998575
  NPD (past)

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1073506713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 WALKER ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134135",
            "telephone_number": "212-226-8866",
            "fax_number": "212-226-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13626 37TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546533",
            "telephone_number": "718-886-1200",
            "fax_number": "718-886-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "EDWIN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-29",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "132804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00377633",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Marie Tamborino, PA-C
• Arianna Beth Tamburri, PT
• Faisal Fouad Tamimi
• Rania Tamimi
• Bryan Tan
• Fengmei Tan
• Isabelle Marie Carolyn Tan
• Janice Y Tan
• Kevin Tan
• Paul Tan, O.D.

• Urology Physician in Flushing, NY
• Providers in Flushing, NY by specialty
• Urology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; 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.

Verify at the official NPI Registry.