Eric Tan, FNP
Individual provider Active NPI Primary Care Nurse Practitioner · Brick, NJ
NPI 1144995754 · NPPES record last updated Aug 16, 2021
Key facts
- NPI
- 1144995754
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- 26NJ01177300 (NJ)
- Practice address
- 35 Beaverson Blvd Ste 6B
Brick, NJ 08723-7859 - Phone
- (732) 262-0622
- NPI assigned
- Aug 16, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Visiting Nurse Association of Central Jersey Community Health Center I
Practice addresses (Care Compare)
35 Broad St
Keyport, NJ 07735-1267
Phone (732) 888-4149
Hospital & facility affiliations
- Hackensack Meridian at Home Monmouth County
- Bayshore Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220104001577 | NJ | Practitioner - Nurse Practitioner | 8224429121 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ01177300 | NJ | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harmony Medical Services of New Jersey LLC | Current |
Accepting new patients | |
| Visiting Nurse Association of Central Jersey Community Health Center I | Current |
Accepting new patients | |
| Harmony Medical Services of New Jersey LLC | Current | Accepting new patients | |
| Visiting Nurse Association of Central Jersey Community Health Center I | Current |
Accepting new patients | |
| Visiting Nurse Association of Central Jersey Community Health Center I | Past | Accepting new patients | |
| Visiting Nurse Association of Central Jersey, Community Health Center, | Past | Accepting new patients | |
| My Home Doctor, LLC | Past | Accepting new patients |
Locations
1301 Main St
Asbury Park, NJ 07712
Phone (732) 774-6333
35 Broad St
Keyport, NJ 07735
Phone (732) 888-4149
28 Valley Rd
Montclair, NJ 07042
Phone (908) 451-8519
Interoperability endpoints
- eric.tan.p1@direct.vnahg.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 26NJ01177300 | NJ | Yes |
Addresses
Primary practice location
35 Beaverson Blvd Ste 6B
Brick, NJ 08723-7859
Mailing address
103 Golf View Blvd
Toms River, NJ 08753-7302
Phone (848) 992-4255
NPI Registry JSON
{
"created_epoch": "1629072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629072000000",
"number": "1144995754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 GOLF VIEW BLVD",
"city": "TOMS RIVER",
"state": "NJ",
"postal_code": "087537302",
"telephone_number": "848-992-4255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 BEAVERSON BLVD STE 6B",
"city": "BRICK",
"state": "NJ",
"postal_code": "087237859",
"telephone_number": "732-262-0622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAN",
"first_name": "ERIC",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-16",
"last_updated": "2021-08-16",
"certification_date": "2021-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "NJ",
"license": "26NJ01177300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brick, NJ
- Dirksen J. Taguiam
- Rachel Taillacq
- Nicolette Rose Takach
- Marie S Tallard
- Allyson M Tamowski
- Victoria Helen Tancsak
- Matthew Tangorra
- Tave Clinic LLC
- Brett Tave
- Ted L. Freeman,DO, PC
All providers in Brick, NJ · Primary Care Nurse Practitioner in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 16, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.