Carlos Castilo Tan, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

27927 Issued in GA

Practice address

3 Washington Ave
Gainesville, GA 30501-4135

Phone

(770) 503-0221

Fax

(770) 503-0023

NPI assigned

Feb 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Georgia Physician Associates, PC

  • Specialist
  • Canton, GA
  • NPI 1528496353
  NPD (past)
• Mip Medical Management

  • Pain Medicine Physician
  • Macon, GA
  • NPI 1376813451
  NPD (past)
• Quality Medical Management Services LLC

  • Specialist
  • Woodstock, GA
  • NPI 1497060016
  NPD (past)
• Surgical Clinic of Griffin-Spalding, P.C.

  • Surgery Physician
  • Griffin, GA
  • NPI 1336470848
  NPD (past)
• The Pain Management Clinic of Woodstock

  • Specialist
  • Gainesville, GA
  • NPI 1134374259
  NPD (past)
• United Spine and Ortho, LLC

  • Pain Medicine Physician
  • Atlanta, GA
  • NPI 1306135421
  NPD (past)
• Nova Medical Center LLC

  • Primary Care Clinic/Center
  • Milwaukee, WI
  • NPI 1336310374
  NPD (past)

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1215901855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WASHINGTON AVE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305014135",
            "telephone_number": "770-503-0221",
            "fax_number": "770-503-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 WASHINGTON AVE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305014135",
            "telephone_number": "770-503-0221",
            "fax_number": "770-503-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "CARLOS",
        "middle_name": "CASTILO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "27927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000304719H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samson Dejene Tadesse, MD
• Jacob Tadros, MD
• Soha P. Taheri, MD
• Theresa Marie Takacs, M.ED, CCC-SLP
• Lauren B Tamplin, FNP
• Diane S Tandy, CNM
• Alexis Yen Tang, CAA
• Rong Tang, CAA
• Frances Adaeze Tangban, NP-C
• Madison Tankersley

• General Practice Physician in Gainesville, GA
• Providers in Gainesville, GA by specialty
• General Practice Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.