Egbert Aung Kyaing Tan

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

28445-20 Issued in WI

Practice address

2640 W Point Rd
Green Bay, WI 54304-1344

Phone

(920) 490-3790

NPI assigned

Sep 25, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Egbert A Tan Professional name

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

PsychiatryAlso: Addiction Medicine

Education

Other, 1976

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

County of BrownGroup PAC ID 1355435900, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• County of Brown

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Green Bay, WI
  • NPI 1942305065

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• County of Brown

  • Public Health or Welfare Agency
  • Green Bay, WI
  • NPI 1134322787
  NPD
• Oneida Nation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Green Bay, WI
  • NPI 1205825130

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1245427111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "899 POST RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105835517",
            "telephone_number": "914-725-5442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 W POINT RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543041344",
            "telephone_number": "920-490-3790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3150 Gershwin Dr",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543114328",
            "country_code": "US",
            "telephone_number": "920-391-4700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "899 Post Rd",
            "address_purpose": "LOCATION",
            "city": "Scarsdale",
            "state": "NY",
            "postal_code": "105835517",
            "country_code": "US",
            "telephone_number": "914-725-5542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAN",
        "first_name": "EGBERT",
        "middle_name": "AUNG KYAING",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-25",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "183140",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "28445-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EGBERT",
            "last_name": "TAN",
            "middle_name": "A",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• James Edward Talley, CRNA
• Matthew Talus, RRT
• Dwight Masaichi Tamanaha, D.C.
• Robert H Tambeaux, MD
• Frinwei Zita Taminang, APNP
• Timothy Edward Tanke, MD
• Lydia G Tanney, LAT
• Aniella Tarantino
• Eric J Tarsi, PT
• Tyler Marie Tatro, PT, DPT

• Psychiatry Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.