Individual provider Active NPI

Shereen Tan, PT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1356357545
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
026126-1 Issued in NY
Practice address
57 W 57TH St
Ste 1406
New York, NY 10019-2802
Phone
(212) 980-7877
NPI assigned
Jul 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 026126-1 NY Primary

Addresses

Primary practice location

57 W 57TH St
Ste 1406
New York, NY 10019-2802

Mailing address

14210 Roosevelt Ave
Apt 315
Flushing, NY 11354-6046
Phone (917) 459-3673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041101000094 NY Practitioner - Physical Therapist in Private Practice 3971565102 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cynergy Chelsea IncGroup PAC ID 9133544174, 5 clinicians

Practice addresses (Care Compare)

135 W 27TH St
FL 2
New York, NY 10001-6226
Phone (212) 255-8080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
026126-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cynergy Chelsea, Inc Physical Therapist CurrentSince Jul 13, 2020 Accepting new patients
Cynergy Physical Therapy, P.C. Physical Therapist CurrentSince Apr 4, 2016 Accepting new patients
Wellness Den Physical Therapy PLLC Physical Therapist PastSince Aug 6, 2023 Accepting new patients
Bienetre Medical PC Physical Therapist Past Accepting new patients
Sports Physical Therapy of New York, P.C. Physical Therapist PastSince Dec 11, 2013 Accepting new patients

Locations

119 W 57th St
Ste 600
New York, NY 10019
Phone (212) 974-7252

134 W 26th St
Rm 1200
New York, NY 10001
Phone (212) 255-8080

135 W 27th St
Fl 2
New York, NY 10001
Phone (212) 255-8080

Organizations & group practices 5

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356357545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14210 ROOSEVELT AVE",
            "address_2": "APT 315",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546046",
            "telephone_number": "917-459-3673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 W 57TH ST",
            "address_2": "STE 1406",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192802",
            "telephone_number": "212-980-7877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "SHEREEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "026126-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.