Active NPI
Djerrick Cu Tan, M.D.
- Diagnostic Radiology Physician
- Mequon, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 47802
- Practice address
- 10945 N Port Washington Rd Ste 201
Mequon, WI 53092-5078 - Phone
- (262) 292-3151
- NPI assigned
- Nov 29, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 1025471 | MA | |
| Diagnostic Radiology Physician | 2085R0202X | MD20361 | RI | |
| Diagnostic Radiology Physician | 2085R0202X | 47802 | WI | Primary |
Addresses
Primary practice location
10945 N Port Washington Rd Ste 201
Mequon, WI 53092-5078
Mailing address
10945 N Port Washington Rd Ste 201
Mequon, WI 53092-5078
Phone (262) 292-3151
Other practice location 1
450 Veterans Memorial Pkwy Bldg 2
East Providence, RI 02914-5300
Phone (401) 435-3041
Other practice location 2
211 Park St
Attleboro, MA 02703-3143
Phone (508) 222-5200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, TN, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Indiana University School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10101 S 27TH St
Franklin, WI 53132-7209
Phone (414) 325-4700
10180 Washington Ave
Mount Pleasant, WI 53177-1604
Phone (414) 973-7830
10950 W Capitol Dr
Wauwatosa, WI 53222-1110
Phone (414) 464-4460
12831 N Port Washington Rd
Mequon, WI 53097-2416
Phone (414) 973-7844
13111 N Port Washington Rd
Mequon, WI 53097-2416
Phone (262) 243-7300
13950 W Capitol Dr
Brookfield, WI 53005-2441
Phone (414) 302-5400
19333 W N Ave
Brookfield, WI 53045-4132
Phone (262) 785-2000
2061 Cheyenne CT
Grafton, WI 53024-9368
Phone (262) 376-1934
2301 N Lake Dr
Milwaukee, WI 53211-4508
Phone (414) 585-1000
3237 S 16TH St
Milwaukee, WI 53215-4526
Phone (414) 647-5000
375 W River Woods Pkwy
Glendale, WI 53212-1080
Phone (414) 973-7842
3801 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-4011
3807 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-8300
3811 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-5300
4935 S 76TH St
Greenfield, WI 53220-4305
Phone (414) 973-7846
5000 W Chambers St
Milwaukee, WI 53210-1650
Phone (414) 447-2000
788 N Jefferson St
Milwaukee, WI 53202-3718
Phone (414) 272-8950
801 S 70TH St
West Allis, WI 53214-3147
Phone (414) 773-6600
9252 N Green Bay Rd
Brown Deer, WI 53209-1104
Phone (414) 270-8150
N112W15415 Mequon Rd
Germantown, WI 53022-3410
Phone (262) 250-7800
N143W6515 Pioneer Rd
Cedarburg, WI 53012-2705
Phone (262) 377-6933
Hospital & facility affiliations
- Ascension Columbia St Marys Hospital Milwaukee
- Ascension All Saints Hospital
- Ascension SE Wisconsin Hospital
- Ascension St Francis Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1025471 | MA | MD | Diagnostic Radiology Physician |
| MD20361 | RI | MD | Diagnostic Radiology Physician |
| 47802 | WI | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ascension Medical Group-Southeast Wisconsin Inc | Diagnostic Radiology | Current | Accepting new patients |
| Advanced Diagnostic Imaging PC | Current | Accepting new patients | |
| Precision Radiology - Illinois LTD | Current | Accepting new patients | |
| Columbia St. Mary'S Hospital Milwaukee Inc | Current | Accepting new patients | |
| Medical X-Ray Consultants, LTD | Diagnostic Radiology | Current | Accepting new patients |
| Premier Radiology Wisconsin, LLC | Diagnostic Radiology | Current | Accepting new patients |
| Advanced Diagnostic Imaging, PC | Diagnostic Radiology | Current | Accepting new patients |
| Middle Tennessee Imaging LLC | Diagnostic Radiology | Current | Accepting new patients |
| Columbia St. Mary'S Hospital Milwaukee, Inc | Current | Accepting new patients | |
| Nol, LLC | Diagnostic Radiology | Current | Accepting new patients |
| Wisconsin Radiology Specialists, S C | Current | Accepting new patients | |
| Rhode Island Medical Imaging Inc | Diagnostic Radiology | Past | Accepting new patients |
| Aurora Advanced Healthcare Inc | Past | Accepting new patients | |
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Past | Accepting new patients | |
| Medical Scanning Consultants, P.a. | Diagnostic Radiology | Past | Accepting new patients |
| Medical Xray Consultants, LTD | Past | Accepting new patients |
Locations (25 of 33)
7435 W Talcott Ave
Chicago, IL 60631
Phone (773) 467-9977
2900 N Lakeshore
Chicago, IL 60657
Phone (773) 665-3240
100 N River Rd
Des Plaines, IL 60016
Phone (847) 297-1800
205 S Northwest Hwy
Park Ridge, IL 60068
Phone (224) 585-7000
3024 Business Park Cir
Goodlettsvlle, TN 37072
Phone (615) 239-2018
1210 Briarville Rd
Bldg F602
Madison, TN 37115
Phone (615) 773-7237
28 White Bridge Pike
Ste 111
Nashville, TN 37205
Phone (615) 986-6153
3443 Dickerson Pike
Ste 400
Nashville, TN 37207
Phone (615) 612-2146
13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400
900 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 717-4121
7400 W Rawson Ave
Ste G40
Franklin, WI 53132
Phone (414) 282-5314
N112W15415 Mequon Rd
Germantown, WI 53022
Phone (262) 250-7800
6900 N Port Washington Rd
Glendale, WI 53217
Phone (414) 270-8100
7080 N Port Washington Rd
Glendale, WI 53217
Phone (414) 228-4940
6080 S 108th St
Hales Corners, WI 53130
Phone (414) 282-5314
12800 N Port Washington Rd
Mequon, WI 53097
Phone (262) 243-3655
13133 N Port Washington Rd
Mequon, WI 53097
Phone (262) 243-5850
2025 W Oklahoma Ave
Ste 121
Milwaukee, WI 53215
Phone (414) 671-1711
1032 S Cesar E Chavez Dr
Milwaukee, WI 53204
500 W Brown Deer Rd
Ste 202
Milwaukee, WI 53217
2323 N Lake Dr
Milwaukee, WI 53211
Phone (414) 291-1000
2745 W Layton Ave
Ste 206
Milwaukee, WI 53221
Phone (414) 281-9665
10180 Washington Ave
Mount Pleasant, WI 53177
Phone (414) 769-4040
1317 W Grand Ave
Prt Washingtn, WI 53074
Phone (262) 268-6998
830 E Green Bay Ave
Saukville, WI 53080
Phone (262) 284-7117
Organizations & group practices 16
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.
-
- Diagnostic Radiology Physician
- Mount Pleasant, WI
- NPI 1952951154
-
- Internal Medicine Physician
- Glendale, WI
- NPI 1609881077
Diagnostic Radiology
-
- Multi-Specialty Clinic/Center
- Milwaukee, WI
- NPI 1023064482
-
- Internal Medicine Physician
- Goodlettsville, TN
- NPI 1093741464
Diagnostic Radiology
-
- Vascular & Interventional Radiology Physician
- Alexandria, MN
- NPI 1386601383
Diagnostic Radiology, WI
-
- Diagnostic Radiology Physician
- Dickson, TN
- NPI 1770667289
-
- Diagnostic Radiology Physician
- Dickson, TN
- NPI 1003910688
-
- Psychiatric Hospital Unit
- Mequon, WI
- NPI 1417600909
-
- Durable Medical Equipment & Medical Supplies
- Lewisburg, TN
- NPI 1922846559
-
- Durable Medical Equipment & Medical Supplies
- Summit, WI
- NPI 1477186633
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Racine, WI
- NPI 1639123284
-
- General Acute Care Hospital
- Milwaukee, WI
- NPI 1427007384
-
- Rehabilitation Hospital Unit
- Brookfield, WI
- NPI 1861417362
-
- General Acute Care Hospital
- Milwaukee, WI
- NPI 1225087190
-
- General Acute Care Hospital
- Milwaukee, WI
- NPI 1871656082
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771804800000",
"number": "1124002654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10945 N PORT WASHINGTON RD STE 201",
"city": "MEQUON",
"state": "WI",
"postal_code": "530925078",
"telephone_number": "262-292-3151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10945 N PORT WASHINGTON RD STE 201",
"city": "MEQUON",
"state": "WI",
"postal_code": "530925078",
"telephone_number": "262-292-3151"
}
],
"practiceLocations": [
{
"address_1": "450 Veterans Memorial Pkwy Bldg 2",
"address_purpose": "LOCATION",
"city": "East Providence",
"state": "RI",
"postal_code": "029145300",
"country_code": "US",
"telephone_number": "401-435-3041",
"fax_number": "401-435-3042",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "211 Park St",
"address_purpose": "LOCATION",
"city": "Attleboro",
"state": "MA",
"postal_code": "027033143",
"country_code": "US",
"telephone_number": "508-222-5200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TAN",
"first_name": "DJERRICK",
"middle_name": "CU",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-29",
"last_updated": "2026-02-23",
"certification_date": "2026-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MA",
"license": "1025471",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "RI",
"license": "MD20361",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WI",
"license": "47802",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mequon, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.