Kwei Ham Daniel Tan, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

313583 Issued in NY

Practice address

415 E Main St
Endicott, NY 13760-4925

Phone

(607) 785-2584

NPI assigned

Jun 26, 2018

Last updated

Jan 17, 2023By 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 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Family Practice

Education

Lake Erie College of Osteopathic Medicine, Erie, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Groton Community Health Care Ctr Res Care Fac Nursing home, Groton, NY, CCN 335658

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kwei.tan@direct.lourdes.com

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.

• Kwei Ham Daniel Tan, DO PLLC

  • Family Medicine Physician
  • Groton, NY
  • NPI 1558194035
  Medicare reassignment NPD
• Our Lady of Lourdes Memorial Hospital Inc.

  dba Lourdes

  • General Acute Care Hospital
  • Binghamton, NY
  • NPI 1629087580
  Medicare reassignment NPD
• JDS Medical Services PC

  • Emergency Medicine Physician
  • Englewood, NJ
  • NPI 1174224653

  NY

  Medicare reassignment NPD
• Medical Director Services PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Princess Anne, MD
  • NPI 1871955807

  NY

  Medicare reassignment NPD
• Our Lady of Lourdes Memorial Hospital, Inc.

  dba Lourdes

  • Family Medicine Physician
  • Binghamton, NY
  • NPI 1063557189
  NPD
• Our Lady of Lourdes Memorial Hospital, Inc.

  • Specialty Pharmacy
  • Johnson City, NY
  • NPI 1730982596
  NPD
• Twin Tier Pathology Associates, PC

  • Clinical Pathology/Laboratory Medicine Physician
  • Binghamton, NY
  • NPI 1770577470
  NPD
• Groton Community Health Care Center Inc

  • Skilled Nursing Facility
  • Groton, NY
  • NPI 1760437362
  NPD (past)

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

• Groton Community Health Care Center Inc

  • Skilled Nursing Facility
  • Groton, NY
  • NPI 1760437362

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1326533977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 FORBES AVENUE",
            "address_2": "FORBES TOWER - PLAZA LEVEL SUITE 140",
            "city": "PITTSBURG",
            "state": "PA",
            "postal_code": "15213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 E MAIN ST",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137604925",
            "telephone_number": "607-785-2584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 Memorial Dr.",
            "address_purpose": "LOCATION",
            "city": "Farrell",
            "state": "PA",
            "postal_code": "16121",
            "country_code": "US",
            "telephone_number": "724-981-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAN",
        "first_name": "KWEI HAM DANIEL",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-26",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "313583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwei.tan@direct.lourdes.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "415 E Main St",
            "city": "Endicott",
            "state": "NY",
            "country_code": "US",
            "postal_code": "137604925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sullivan Park Healthcare Center, Inc (The Waters of Endicott)
• Christopher Jay Sullivan, D.C.
• Susan Connelly Licensed Clinical Social Worker, P.C.
• Fatima Syed, DO
• Mary Sze-Tu, LCSW-R
• Denise Tatich, M.S./CCC-SLP
• Abigail Joyce Terrill
• Cindy Lynn Tesch, LMHC-D
• Kendra L Testa
• Smriti Thakur, MD

• Family Medicine Physician in Endicott, NY
• Providers in Endicott, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.