Lucy Tan

Primary specialty

Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X

License

25MA13037100 Issued in NJ

Practice address

3401 Civic Center Blvd
Philadelphia, PA 19104-4319

Phone

(215) 590-3749

NPI assigned

Mar 21, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Pediatric Medicine

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Surgical Critical Care Physician
  • Red Bank, NJ
  • NPI 1215989249
  Medicare reassignment

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

{
    "created_epoch": "1584748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1083240014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NEWMAN SPRINGS ROAD",
            "address_2": "BLDG. 2, SUITE 220",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "07701",
            "telephone_number": "732-807-0877",
            "fax_number": "201-751-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-3749"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Prospect Ave Fl 3",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076011915",
            "country_code": "US",
            "telephone_number": "551-996-5207",
            "fax_number": "551-996-4969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAN",
        "first_name": "LUCY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-21",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "PA",
            "license": "MT227886",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NJ",
            "license": "25MA13037100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan M Tan, MD MPH
• Jonathan Peng-Sui Tan, PSY.D.
• Katherine Tan
• Kevin Charles Tan, MD
• Kimty Tan, D.M.D
• Marie Teresa Tan, MD
• Sarina Ester Tan
• Shi Min Tan, MD
• Shu-Ling C Tan, PHYSICAL THERAPIST
• Stephanie Tan, OD

• Pediatric Pulmonology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Pulmonology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.