Individual provider Active NPI

John C. Tangeman, M.D.

  • Internal Medicine Physician
  • Cheektowaga, NY
National Provider Identifier
1073559001
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
159518 Issued in NY
Practice address
225 Como Park Blvd
Cheektowaga, NY 14227-1416
Phone
(716) 686-8386
Fax
(716) 686-8111
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 159518 NY
Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician 2081H0002X 159518 NY
Pain Medicine Physician 208VP0000X 159518 NY
Internal Medicine Physician 207R00000X 159518 NY Primary

Addresses

Primary practice location

225 Como Park Blvd
Cheektowaga, NY 14227-1416

Mailing address

225 Como Park Blvd
Cheektowaga, NY 14227-1416
Phone (716) 686-8460

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080502000429 NY Practitioner - Internal MedicinePractitioner - Hospice/Palliative CarePractitioner - Pain Management 0547349417 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Medical Partners, PLLC Pain Medicine CurrentSince Jul 1, 2007 Accepting new patients

Locations

100 High St
Buffalo, NY 14203
Phone (716) 632-3700

225 Como Park Blvd
Cheektowaga, NY 14227
Phone (716) 686-1900

908 Niagara Falls Blvd
Ste 208
North Tonawanda, NY 14120
Phone (716) 649-1613

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hospice Buffalo, Inc.Cheektowaga, NY, CCN 331502 Hospice W-2 Managing Employee Jul 6, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 1

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1073559001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 COMO PARK BLVD",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142271416",
            "telephone_number": "716-686-8460",
            "fax_number": "716-686-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 COMO PARK BLVD",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142271416",
            "telephone_number": "716-686-8386",
            "fax_number": "716-686-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANGEMAN",
        "first_name": "JOHN",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "NY",
            "license": "159518",
            "primary": false
        },
        {
            "code": "2081H0002X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Hospice and Palliative Medicine",
            "state": "NY",
            "license": "159518",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NY",
            "license": "159518",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "159518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheektowaga, NY

Sources for this page

Verify at the official NPI Registry.