Individual provider Active NPI

Wei Yan Tan, MD

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1174511000
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
225855 Issued in NY
Practice address
5618 7TH Ave
Brooklyn, NY 11220-3510
Phone
(718) 439-3284
Fax
(718) 439-5029
NPI assigned
Oct 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 225855 NY Primary

Addresses

Primary practice location

5618 7TH Ave
Brooklyn, NY 11220-3510

Mailing address

5618 7TH Ave
Brooklyn, NY 11220-3510
Phone (718) 439-3284

Other identifiers 1

IdentifierTypeStateIssuer
225855OtherNYLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20140820000653 NY Practitioner - Internal Medicine 0042494759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5618 7TH Ave
Brooklyn, NY 11220-3510
Phone (718) 439-3284

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wei Yan Tan Physician. P.C. Internal Medicine CurrentSince Sep 5, 2013 Accepting new patients

Locations

5618 7th Ave
Brooklyn, NY 11220
Phone (718) 439-3284

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DGCJCA
  • FHIR API: https://fhir4.healow.com/fhir/r4/DGCJCA/Endpoint/DGCJCA

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.

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427414400000",
    "number": "1174511000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5618 7TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203510",
            "telephone_number": "718-439-3284",
            "fax_number": "718-439-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5618 7TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203510",
            "telephone_number": "718-439-3284",
            "fax_number": "718-439-5029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "WEI",
        "middle_name": "YAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2015-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "225855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "225855",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.