NPIMap

Individual provider Active NPI

Stephen Michael Tann, M.D.

  • Cardiovascular Disease Physician
  • Carson City, NV
National Provider Identifier
1093751091
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
11880 Issued in NV
Practice address
1470 Medical Parkway
Suite 160
Carson City, NV 89703-4636
Phone
(775) 445-7650
Fax
(775) 882-4206
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 11880 NV Primary
Interventional Cardiology Physician 207RI0011X 11880 NV

Addresses

Primary practice location

1470 Medical Parkway
Suite 160
Carson City, NV 89703-4636

Mailing address

PO Box 4390
Carson City, NV 89702-4390
Phone (775) 445-7650

Other identifiers 2

IdentifierTypeStateIssuer
CC4954OtherBLUE CROSS BLUE SHIELD
100510311MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060809000017 NV Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9335142561 Reassigns benefits to 1 organization
Practice locations: Carson City, NV
I20170220000691 OH Practitioner - Cardiovascular Disease (Cardiology) 9335142561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Ohio State University College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Coast Professional Company, LLCGroup PAC ID 6305810201, 105 clinicians

Practice addresses (Care Compare)

1111 Hayes Ave
Sandusky, OH 44870-3323
Phone (419) 557-7400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting16
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11880NVMDCardiovascular Disease Physician
22944SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Open Door Community Health Centers Current Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
North Coast Professional Company, LLC Family Medicine CurrentSince Dec 24, 2016 Accepting new patients
North Coast Professional Company, LLC CurrentSince Dec 24, 2016 Accepting new patients

Locations

785 18th St
Arcata, CA 95521
Phone (707) 822-2481

1275 8th St
Arcata, CA 95521

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

1111 Hayes Ave
Sandusky, OH 44870
Phone (419) 557-7455

1031 Pierce St
Sandusky, OH 44870
Phone (419) 557-5541

703 Tyler St
Ste 352
Sandusky, OH 44870
Phone (419) 557-6785

Interoperability endpoints

  • Direct secure messaging: stann87356@direct.renown.org

Organizations & group practices 5

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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": "1410998400000",
    "number": "1093751091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4390",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897024390",
            "telephone_number": "775-445-7650",
            "fax_number": "775-882-4206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 MEDICAL PARKWAY",
            "address_2": "SUITE 160",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897034636",
            "telephone_number": "775-445-7650",
            "fax_number": "775-882-4206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANN",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NV",
            "license": "11880",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NV",
            "license": "11880",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "CC4954",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100510311",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson City, NV

Sources for this page

Verify at the official NPI Registry.