Active NPI
Sovannary Tan
- Registered Nurse
- Bronx, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 57020
- Practice address
- 111 E 210TH Street
Bronx, NY 10467 - Phone
- (718) 920-4316
- NPI assigned
- Sep 5, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 57020 | NY | Primary |
Addresses
Primary practice location
111 E 210TH Street
Bronx, NY 10467
Mailing address
11 Huron Road
Yonkers, NY 10710
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
33 -57 Harrison St
Johnson City, NY 13790-2107
Phone (607) 763-6101
52 Harrison St
Johnson City, NY 13790-2120
Phone (607) 763-5898
54 Main St
Candor, NY 13743-1619
Phone (607) 659-7272
600 Roe Ave
Elmira, NY 14905-1629
Phone (607) 737-4100
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.14 of 100
- Quality
- 86.74
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 70.09
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57020 | NY | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Health Services Hospitals, Inc. | Current | Accepting new patients | |
| Montefiore Medical Center | Current | Accepting new patients | |
| Montefiore Medical Center | Current | Accepting new patients | |
| Jamaica Anesthesiologist, PC | Current | Accepting new patients |
Locations
111 E 210th St
Bronx, NY 10467
4500 Parsons Blvd
Flushing, NY 11355
Phone (718) 670-5631
80 Marcus Dr
Melville, NY 11747
Phone (631) 391-7889
8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088
Organizations & group practices 6
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.
-
- Multi-Specialty Clinic/Center
- Johnson City, NY
- NPI 1962463851
-
- Anesthesiology Physician
- Elmira, NY
- NPI 1285684373
-
- Anesthesiology Physician
- Jamaica, NY
- NPI 1508812892
-
- Anesthesiology Physician
- Bronx, NY
- NPI 1063525152
-
- Multi-Specialty Clinic/Center
- Corning, NY
- NPI 1134178635
-
- Community/Retail Pharmacy
- Bronx, NY
- NPI 1194183715
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Elmira, NY
- NPI 1083605661
-
- General Acute Care Hospital
- Binghamton, NY
- NPI 1518998699
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346803200000",
"number": "1326397431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 HURON ROAD",
"city": "YONKERS",
"state": "NY",
"postal_code": "10710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 E 210TH STREET",
"city": "BRONX",
"state": "NY",
"postal_code": "10467",
"telephone_number": "718-920-4316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAN",
"first_name": "SOVANNARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-05",
"last_updated": "2012-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "57020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.