Kim Kelby Sia Tan, RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1253233 Issued in TX

Practice address

3452 Lake Lynda Dr Ste 2001
Orlando, FL 32817-1430

Phone

(800) 774-7785

NPI assigned

Aug 9, 2016

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 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Theracovery LLC

  • Physical Therapist
  • Harlingen, TX
  • NPI 1982385316
  Medicare reassignment NPD

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

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1114471083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3452 LAKE LYNDA DR STE 2001",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328171430",
            "telephone_number": "800-774-7785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3452 LAKE LYNDA DR STE 2001",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328171430",
            "telephone_number": "800-774-7785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "KIM KELBY",
        "middle_name": "SIA",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-09",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1253233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS PHYSICAL THERAPY LICENSE",
            "identifier": "1253233",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christian H Tan, M.D.
• Grace Rodriguez Tan, PHYSICAL THERAPIST
• James Tang Tan, PHYSICAL THERAPIST
• Jesse Ong Tan, M.D.
• Kendall Brittany Tan, CAA
• Akiho Tanaka, PH.D.
• Alex Tande, PTA
• Sanjay Tandon, MD
• Deepa Taneja, MD
• Kelly Tanga, BCBA

• Physical Therapist in Orlando, FL
• Providers in Orlando, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.