Active NPI
Surinder Singh Tank, MD
- Neonatal-Perinatal Medicine Physician
- Shreveport, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- MD 205253
- Practice address
- 1453 E Bert Kouns Industrial Loop
Department of Pediatrics
Shreveport, LA 71105-6800 - Phone
- (318) 681-4316
- Fax
- (318) 675-6059
- NPI assigned
- May 14, 2008
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD.205253 | LA | |
| Pediatrics Physician | 208000000X | 002019 | GA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 0101247049 | VA | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | MD 205253 | LA | Primary |
Addresses
Primary practice location
1453 E Bert Kouns Industrial Loop
Department of Pediatrics
Shreveport, LA 71105-6800
Mailing address
PO Box 846098
Dallas, TX 75284-6098
Phone (903) 606-6400
Other practice location 1
1453 E Bert Koun Loop
Shreveport, LA 71105
Phone (318) 681-7379
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD 205253 | LA | MD | Neonatal-Perinatal Medicine Physician |
| 002019 | GA | MD | Physical Therapy Assistant |
| 0101247049 | VA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Magella Medical Associates Billing, Inc. | Neonatal-Perinatal Medicine | Current | Accepting new patients |
| Christus Trinity Clinic Texas | Pediatrics | Current | Accepting new patients |
| Pediatrix Medical Group of Texas Billing, Inc. | Pediatrics | Current | Accepting new patients |
| Christus Trinity Clinic Texas | Current | Accepting new patients | |
| Christus Health Northern Louisiana | Past | Accepting new patients |
Locations
3330 Masonic Dr
Alexandria, LA 71301
Phone (318) 448-6917
1453 E Bert Kouns Industrial Loop
#L
Shreveport, LA 71105
1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138
7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000
3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115
3001 George Bush Hwy
Ste 250
Richardson, TX 75082
Phone (888) 822-2855
Organizations & group practices 5
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.
-
- Neonatal-Perinatal Medicine Physician
- Round Rock, TX
- NPI 1083631071
-
- Neonatal-Perinatal Medicine Physician
- Houston, TX
- NPI 1649377359
Pediatrics
-
- Rural Health Clinic/Center
- Winnsboro, TX
- NPI 1801673165
-
- General Acute Care Hospital
- Shreveport, LA
- NPI 1417950106
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686614400000",
"number": "1205003605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 846098",
"city": "DALLAS",
"state": "TX",
"postal_code": "752846098",
"telephone_number": "903-606-6400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1453 E BERT KOUNS INDUSTRIAL LOOP",
"address_2": "DEPARTMENT OF PEDIATRICS",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711056800",
"telephone_number": "318-681-4316",
"fax_number": "318-675-6059"
}
],
"practiceLocations": [
{
"address_1": "1453 E Bert Koun Loop",
"address_purpose": "LOCATION",
"city": "Shreveport",
"state": "LA",
"postal_code": "71105",
"country_code": "US",
"telephone_number": "318-681-7379",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TANK",
"first_name": "SURINDER",
"middle_name": "SINGH",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-14",
"last_updated": "2023-06-13",
"certification_date": "2023-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "LA",
"license": "MD.205253",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "002019",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "VA",
"license": "0101247049",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "LA",
"license": "MD 205253",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.