Individual provider Active NPI

Royland Tan, MD

  • Anesthesiology Physician
  • Newark, NJ
National Provider Identifier
1124026893
Registry record updated Mar 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA06216700 Issued in NJ
Practice address
268 Martin Luther King Jr Blvd
Newark, NJ 07102-2011
Phone
(973) 877-5034
Fax
(973) 877-5231
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA62167 NJ
Anesthesiology Physician 207L00000X 25MA06216700 NJ Primary

Addresses

Primary practice location

268 Martin Luther King Jr Blvd
Newark, NJ 07102-2011

Mailing address

3998 Fair Ridge Drive
Suite 300
Fairfax, VA 22033
Phone (703) 295-9360

Other identifiers 1

IdentifierTypeStateIssuer
6670407MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20100820000646 NJ Practitioner - Anesthesiology 6901719384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North American Partners in Anesthesia of New Jersey LLCGroup PAC ID 5890867410, 156 clinicians

Practice addresses (Care Compare)

111 Central Ave
Newark, NJ 07102-1909
Phone (973) 877-5000

703 Main St
Paterson, NJ 07503-2621
Phone (973) 754-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA62167NJMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia of New Jersey LLC Anesthesiology CurrentSince May 15, 2013 Accepting new patients

Locations

1 Clara Maass Dr
Belleville, NJ 07109
Phone (973) 450-2008

630 E Palisade Ave
Englewood Cliffs, NJ 07632
Phone (201) 503-0302

300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200

6 Chestnut Ridge Rd
Montvale, NJ 07645
Phone (201) 391-4700

111 Central Ave
Newark, NJ 07102
Phone (973) 877-5060

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

246 Hamburg Tpke
Wayne, NJ 07470
Phone (973) 653-3366

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427241600000",
    "number": "1124026893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3998 FAIR RIDGE DRIVE",
            "address_2": "SUITE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22033",
            "telephone_number": "703-295-9360",
            "fax_number": "703-766-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 MARTIN LUTHER KING JR BLVD",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071022011",
            "telephone_number": "973-877-5034",
            "fax_number": "973-877-5231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "ROYLAND",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2015-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA62167",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA06216700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6670407",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.