Active NPI
Kong Tan, MD
- Anatomic Pathology & Clinical Pathology Physician
- Holmdel, NJ
National Provider Identifier
1184667289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 25MA03121400
- Practice address
- 727 N Beers St
Holmdel, NJ 07733-1514 - Phone
- (732) 739-5847
- NPI assigned
- Jun 14, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 25MA03121400 | NJ | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 25MA03121400 | NJ | Primary |
Addresses
Primary practice location
727 N Beers St
Holmdel, NJ 07733-1514
Mailing address
PO Box 60280
Charleston, SC 29419-0280
Phone (732) 739-5847
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0152871 | Medicaid | NJ | |
| 2406192000 | Other | NJ | AMERIHEALTH # |
| 221494442 | Other | NJ | TAX ID# |
| 60014873 | Other | NJ | HORIZON NJ HEALTH # |
| P3617811 | Other | NJ | OXFORD # |
| P00247907 | Other | NJ | RR MDCR # |
| XK5557 | Other | NJ | HEALTHNET # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294099200000",
"number": "1184667289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60280",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294190280",
"telephone_number": "732-739-5847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "727 N BEERS ST",
"city": "HOLMDEL",
"state": "NJ",
"postal_code": "077331514",
"telephone_number": "732-739-5847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAN",
"first_name": "KONG",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-14",
"last_updated": "2011-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NJ",
"license": "25MA03121400",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "NJ",
"license": "25MA03121400",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0152871",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH #",
"identifier": "2406192000",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID#",
"identifier": "221494442",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HORIZON NJ HEALTH #",
"identifier": "60014873",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD #",
"identifier": "P3617811",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MDCR #",
"identifier": "P00247907",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET #",
"identifier": "XK5557",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Holmdel, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.