John U. Tan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01042239A Issued in IN

Practice address

1473 E State Road 44
Suite 3
Connersville, IN 47331-8374

Phone

(765) 825-2229

NPI assigned

Jan 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et1220.epichosted.com/FHIRProxy/api/FHIR/R4/
• Direct secure messaging: jtan301352@reidhealth.direct-ci.com

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.

• Reid Physician Associates, Inc.

  dba Reid Health Physician Associates

  • Internal Medicine Physician
  • Richmond, IN
  • NPI 1265689111
  Medicare reassignment NPD
• Fayette County Pediatrics LLC

  • Pediatrics Physician
  • Connersville, IN
  • NPI 1972583227
  NPD (past) Authorized official
• Reid Physician Associates, Inc

  dba Reid Health X-Ray Winchester

  • Radiology Clinic/Center
  • Winchester, IN
  • NPI 1417653221
  NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• Reid Health Ambulance, Inc.

  • Ambulance
  • Richmond, IN
  • NPI 1205308822
  NPD (past)

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1093795395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 REID PKWY",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741157",
            "telephone_number": "765-825-2229",
            "fax_number": "765-825-9767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1473 E STATE ROAD 44",
            "address_2": "SUITE 3",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473318374",
            "telephone_number": "765-825-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "JOHN",
        "middle_name": "U.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01042239A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200129020",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000705820",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jtan301352@ReidHealth.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Reid Physician Associates, Inc.",
            "address_1": "1473 E State Road 44",
            "address_2": "Suite 3",
            "city": "Connersville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473318374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• SRC Pharmacy LLC
• Pauline Stanton, LCSW
• Allison Struewing, PHARMD
• Mark Edward Sullenbarger, PTA
• Suresh M Patel MD PMC
• Jillian L Tebbe, LCSW
• Renee Anne Telker, RN
• Clay Tenbarge, DC
• The Eye Center Group LLC (Connersville Eye Center)
• Dashell Lynn Tout

• Pediatrics Physician in Connersville, IN
• Providers in Connersville, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.