Individual provider Active NPI

Bryan E Xin Tan, MD

  • Cardiovascular Disease Physician
  • Chicago, IL
National Provider Identifier
1366937211
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036180418 Issued in IL
Practice address
5841 S Maryland Ave
Chicago, IL 60637-1443
Phone
(773) 702-9461
NPI assigned
Jun 23, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 036180418 IL Primary
Hospitalist Physician 208M00000X 311202 NY

Addresses

Primary practice location

5841 S Maryland Ave
Chicago, IL 60637-1443

Mailing address

180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686
Phone (773) 702-1150

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210715000245 NY Practitioner - Hospitalist 0749531820 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036180418ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital Single Specialty CurrentSince Jul 5, 2021 Accepting new patients
United Memorial Medical Center Single Specialty Current Accepting new patients
Newark Wayne Community Hospital Single Specialty CurrentSince Jul 5, 2021 Accepting new patients
United Memorial Medical Center Single Specialty CurrentSince Jul 5, 2021 Accepting new patients
Clifton Springs Sanitarium Co Single Specialty CurrentSince Jul 5, 2021 Accepting new patients
Rochester General Hospital Single Specialty CurrentSince Jul 5, 2021 Accepting new patients
The Unity Hospital of Rochester Single Specialty Current Accepting new patients
The Unity Hospital of Rochester Single Specialty CurrentSince Jul 5, 2021 Accepting new patients
Newark Wayne Community Hospital Single Specialty CurrentSince Jul 5, 2021 Accepting new patients

Locations

229 Summit St
Ste 1
Batavia, NY 14020
Phone (585) 343-4440

16 Bank St
Batavia, NY 14020
Phone (585) 344-4800

2 Coulter Rd
Clifton Springs, NY 14432
Phone (315) 462-1472

1200 Driving Park Ave
Newark, NY 14513
Phone (315) 332-2266

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1529712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1366937211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276686",
            "telephone_number": "773-702-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "773-702-9461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "BRYAN E XIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-23",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036180418",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "311202",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.