Alfonso A Tan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

22583 Issued in AZ

Practice address

6242 E Arbor Ave # 111-113
Mesa, AZ 85206-1309

Phone

(480) 536-6863

Fax

(480) 718-1301

NPI assigned

Sep 28, 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: atan@hmg.gwaydirect.com

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1295826519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6242 E ARBOR AVE # 111-113",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061309",
            "telephone_number": "480-536-6863",
            "fax_number": "480-718-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6242 E ARBOR AVE # 111-113",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061309",
            "telephone_number": "480-536-6863",
            "fax_number": "480-718-1301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6844 E Brown Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852073758",
            "country_code": "US",
            "telephone_number": "480-832-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAN",
        "first_name": "ALFONSO",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "22583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Chandler",
            "affiliation": "Y",
            "affiliationName": "Newco Hatfield Medical Group PLLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6242 E Arbor Ave # 111-113",
            "city": "Mesa",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852061309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Othniel John Talposh
• Marvin K. Tam, M.D.
• Tamar K Gottfried MD, PLC
• Michelle Tamer
• McKenna Tammo, PA-C
• Xin Tan, M.D., PH.D.
• Nicole Tancredi, MSN, APRN, FNP-C, RN
• Tandem Behavior Health Care
• Varun Tandon, MD
• Tanesha'S Loving in Home Care LLC

• Internal Medicine Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.