Enrico Tan, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

36002613 Issued in OH

Practice address

410 E State St
Athens, OH 45701-1819

Phone

(740) 592-2366

Fax

(740) 594-2871

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

College of Podiatric Med and Surgery, Des Moines University, 1989

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297641600000",
    "number": "1346260429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 E STATE ST",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457011819",
            "telephone_number": "740-592-2366",
            "fax_number": "740-594-2871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 E STATE ST",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457011819",
            "telephone_number": "740-592-2366",
            "fax_number": "740-594-2871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "ENRICO",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2011-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36002613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0765159",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS PROV NUMBER",
            "identifier": "000000123607",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0784560001",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Florah Deann Tackett, CNP
• Leslie Tackett
• Erin Taggart
• Sheila Taggart
• Mychaela A Talieh
• Tasc of Southeast Ohio, Inc.
• Dallin Tavoian, MS AT
• Colleen Rachelle Tawater
• Nadia Yousuf Tayeb, M.D.
• Ashley Taylor

• Podiatrist in Athens, OH
• Providers in Athens, OH by specialty
• Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; 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.