Active NPI
Tander Lee Simberloff, MD
- Internal Medicine Physician
- Johnson City, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- CMD19197
- Practice address
- 3 Professional Park Dr Ste 31
Johnson City, TN 37604-6529 - Phone
- (423) 424-3570
- Fax
- (423) 631-0544
- NPI assigned
- Apr 2, 2020
- Last updated
- Nov 28, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 71817 | TN | |
| Hospice and Palliative Medicine (Internal Medicine) Physician | 207RH0002X | 71817 | TN | |
| Internal Medicine Physician | 207R00000X | CMD19197 | RI | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
3 Professional Park Dr Ste 31
Johnson City, TN 37604-6529
Mailing address
3 Professional Park Dr Ste 31
Johnson City, TN 37604-6529
Phone (423) 434-3570
Other practice location 1
400 N State Of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6111
Other practice location 2
4 Sheridan Sq Ste 200
Kingsport, TN 37660-7435
Phone (423) 246-7931
Other practice location 3
2202 N John B Dennis Hwy Ste 110
Kingsport, TN 37660-5904
Phone (423) 578-8400
Other practice location 4
1 Medical Park Blvd Ste 210E
Bristol, TN 37620-7468
Phone (423) 844-5500
Other practice location 5
325 N State Of Franklin Rd Fl 2
Johnson City, TN 37604-6092
Phone (423) 433-6757
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- East Tennessee State University Quillen College of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3 Professional Park Dr
Suite 31
Johnson City, TN 37604-6529
Phone (423) 434-3570
325 N State of Franklin Rd
FL 2
Johnson City, TN 37604-6092
Phone (423) 439-7280
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.76 of 100
- Quality
- 83.09
- Promoting interoperability
- 99
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CMD19197 | RI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Education Assistance Corporation | Internal Medicine | Current | Accepting new patients |
| WPS Providers Inc | Current | Accepting new patients | |
| Medical Education Assistance Corporation | Internal Medicine | Past | Accepting new patients |
Locations
1 Medical Park Blvd
Ste 210E
Bristol, TN 37620
Phone (423) 224-4000
3 Professional Park Dr
Ste 31
Johnson City, TN 37604
Phone (423) 232-6900
400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310
1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565
400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200
325 N State of Franklin Rd
Fl 2
Johnson City, TN 37604
Phone (423) 439-7280
2202 N John B Dennis Hwy
Ste 110
Kingsport, TN 37660
Phone (423) 578-8400
4 Sheridan Sq
Ste 200
Kingsport, TN 37660
Phone (423) 246-7931
Organizations & group practices 3
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.
-
dba ETSU Physicians and Associates
- Internal Medicine Physician
- Johnson City, TN
- NPI 1235180480
-
- General Practice Physician
- Kingsport, TN
- NPI 1003904095
-
- Internal Medicine Physician
- Kingsport, TN
- NPI 1245509280
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Woodridge Hospital
- Psychiatric Hospital Unit
- Johnson City, TN
- NPI 1023434339
-
dba Johnson City Medical Center
- Psychiatric Hospital Unit
- Johnson City, TN
- NPI 1962915652
-
dba Johnson City Medical Center
- General Acute Care Hospital
- Johnson City, TN
- NPI 1972606465
-
dba Holston Valley Medical Center
- General Acute Care Hospital
- Kingsport, TN
- NPI 1487690400
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732752000000",
"number": "1083243083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 PROFESSIONAL PARK DR STE 31",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376046529",
"telephone_number": "423-434-3570",
"fax_number": "423-631-0544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 PROFESSIONAL PARK DR STE 31",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376046529",
"telephone_number": "423-424-3570",
"fax_number": "423-631-0544"
}
],
"practiceLocations": [
{
"address_1": "400 N State Of Franklin Rd",
"address_purpose": "LOCATION",
"city": "Johnson City",
"state": "TN",
"postal_code": "376046035",
"country_code": "US",
"telephone_number": "423-431-6111",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4 Sheridan Sq Ste 200",
"address_purpose": "LOCATION",
"city": "Kingsport",
"state": "TN",
"postal_code": "376607435",
"country_code": "US",
"telephone_number": "423-246-7931",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2202 N John B Dennis Hwy Ste 110",
"address_purpose": "LOCATION",
"city": "Kingsport",
"state": "TN",
"postal_code": "376605904",
"country_code": "US",
"telephone_number": "423-578-8400",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Medical Park Blvd Ste 210E",
"address_purpose": "LOCATION",
"city": "Bristol",
"state": "TN",
"postal_code": "376207468",
"country_code": "US",
"telephone_number": "423-844-5500",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "325 N State Of Franklin Rd Fl 2",
"address_purpose": "LOCATION",
"city": "Johnson City",
"state": "TN",
"postal_code": "376046092",
"country_code": "US",
"telephone_number": "423-433-6757",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SIMBERLOFF",
"first_name": "TANDER",
"middle_name": "LEE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-02",
"last_updated": "2024-11-28",
"certification_date": "2024-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TN",
"license": "71817",
"primary": false
},
{
"code": "207RH0002X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hospice and Palliative Medicine",
"state": "TN",
"license": "71817",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "RI",
"license": "CMD19197",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2024; 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.