Individual provider Active NPI

Mimi Chang Tan, M.D., M.P.H.

  • Gastroenterology Physician
  • Houston, TX
National Provider Identifier
1265753107
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
P4251 Issued in TX
Practice address
1504 Taub Loop
Houston, TX 77030-1608
Phone
(713) 873-3503
NPI assigned
Jun 15, 2010
Last updated
Dec 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X BP10036729 TX
Internal Medicine Physician 207R00000X P4251 TX
Gastroenterology Physician 207RG0100X P4251 TX Primary

Addresses

Primary practice location

1504 Taub Loop
Houston, TX 77030-1608

Mailing address

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-3503

Other practice location 1

1709 Dryden Rd # 5.70
Houston, TX 77030-2400
Phone (713) 798-0190

Other practice location 2

2002 Holcombe Blvd
Houston, TX 77030-4211
Phone (713) 798-0951

Other names 1

  • Mimi Lee Chang Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180926002207 TX Practitioner - GastroenterologyPractitioner - Internal Medicine 3173874393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baylor College of MedicineGroup PAC ID 8224941265, 796 clinicians

Practice addresses (Care Compare)

1504 Taub Loop
Houston, TX 77030-1608
Phone (713) 873-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.87 of 100Reported as group
Quality
87.77
Improvement activities
40
Cost
76.17

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10036729TXMDInternal Medicine Physician
P4251TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Sep 1, 2018 Accepting new patients
Baylor College of Medicine Internal Medicine CurrentSince Sep 1, 2018 Accepting new patients

Locations

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1265753107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 TAUB LOOP",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030",
            "telephone_number": "713-873-3503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 TAUB LOOP",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301608",
            "telephone_number": "713-873-3503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1709 Dryden Rd # 5.70",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302400",
            "country_code": "US",
            "telephone_number": "713-798-0190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2002 Holcombe Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770304211",
            "country_code": "US",
            "telephone_number": "713-798-0951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAN",
        "first_name": "MIMI",
        "middle_name": "CHANG",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-15",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10036729",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P4251",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "P4251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIMI",
            "last_name": "CHANG",
            "middle_name": "LEE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.