Kenneth Tzan, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

833 Chestnut St Ste 210
Philadelphia, PA 19107-4405

Phone

(215) 955-8420

Fax

(215) 503-0429

NPI assigned

Apr 8, 2024

Last updated

Apr 10, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1275386757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST STE 210",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074405",
            "telephone_number": "215-955-5638",
            "fax_number": "215-503-6116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST STE 210",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074405",
            "telephone_number": "215-955-8420",
            "fax_number": "215-503-0429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TZAN",
        "first_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyson Foot Care, PC
• Andrew David Tyson, PA-C
• Charles Germaine Tyson, LCSW, BCD
• Demare Tyson
• Jordan Tzabari, MD
• Andreas Tzavelis, MD, PHD
• Diana Lee Tzeng, M.D.
• Poonam Patel Tzorfas, PHARM.D.
• U R a Blessing Homecare LLC
• U Smile Dental LLC

• Student in an Organized Health Care Education/Training Program in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Student in an Organized Health Care Education/Training Program in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.

Verify at the official NPI Registry.