Individual provider Active NPI

Lucas Tang, MD

  • Family Medicine Physician
  • Fort Wayne, IN
National Provider Identifier
1205520764
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11022953A Issued in IN
Practice address
750 Broadway Ste 350
Fort Wayne, IN 46802-1412
Phone
(260) 423-2675
Fax
(260) 423-6621
NPI assigned
Jun 7, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11022953A IN Primary

Addresses

Primary practice location

750 Broadway Ste 350
Fort Wayne, IN 46802-1412

Mailing address

750 Broadway Ste 350
Fort Wayne, IN 46802-1412
Phone (260) 423-2675

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20230620001796 IN Order and Referring Only - Family PracticePractitioner - Family Practice 8224496476

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: lucas.tang@nhci.eclinicaldirectplus.com
  • Direct secure messaging: lucas.tang.1@17223.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1686096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1205520764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 BROADWAY STE 350",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468021412",
            "telephone_number": "260-423-2675",
            "fax_number": "260-423-6621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 BROADWAY STE 350",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468021412",
            "telephone_number": "260-423-2675",
            "fax_number": "260-423-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANG",
        "first_name": "LUCAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-07",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11022953A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.