Individual provider Active NPI

Michelle Carmen Tan, PA-C

  • Physician Assistant
  • Alpharetta, GA
National Provider Identifier
1356269195
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14280 Issued in GA
Practice address
1725 Windward Concourse Ste 120
Alpharetta, GA 30005-3971
Phone
(470) 731-8010
NPI assigned
Jul 8, 2026
Last updated
Aug 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 14280 GA Primary

Addresses

Primary practice location

1725 Windward Concourse Ste 120
Alpharetta, GA 30005-3971

Mailing address

1725 Windward Concourse Ste 120
Alpharetta, GA 30005-3971
Phone (470) 731-8010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14280GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Dermatology of Atlanta Dermatology CurrentSince Aug 1, 2026 Accepting new patients

Locations

1725 Windward Concourse
Ste 120
Alpharetta, GA 30005
Phone (470) 731-8010

Interoperability endpoints

  • FHIR API: https://specdermatl.mmi.prod.fhir.ema-api.com/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1783468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1356269195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 WINDWARD CONCOURSE STE 120",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300053971",
            "telephone_number": "470-731-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 WINDWARD CONCOURSE STE 120",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300053971",
            "telephone_number": "470-731-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "MICHELLE",
        "middle_name": "CARMEN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-08",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "14280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

Verify at the official NPI Registry.