Mark Tan, M.D., P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

165674 Issued in NY

Legal business name

MARK TAN, M.D., P.C.

Practice address

222 Middle Country Rd
Suite # 312
Smithtown, NY 11787

Phone

(631) 821-5893

Fax

(631) 724-8901

NPI assigned

Dec 20, 2007

Last updated

Jan 7, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark Tan, M.D.NPI 1083770580

Title

Owner

Phone

(631) 724-8900

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark Tan, M.D.

  • Rheumatology Physician
  • Smithtown, NY
  • NPI 1083770580
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199664000000",
    "number": "1386828861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 MIDDLE COUNTRY RD",
            "address_2": "SUITE # 312",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872871",
            "telephone_number": "631-821-5893",
            "fax_number": "631-724-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 MIDDLE COUNTRY RD",
            "address_2": "SUITE # 312",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "11787",
            "telephone_number": "631-821-5893",
            "fax_number": "631-724-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK TAN, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-20",
        "last_updated": "2008-01-07",
        "status": "A",
        "authorized_official_last_name": "TAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-724-8900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "165674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00986705",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Marine, FNP-C
• Luiziana Manuela Marinescu, M.D.
• Marjorie C. Ravitz DPM PC
• Mark J. Zuckerman, Physician, P.C.
• Mark Jan Sterling MD PC
• Marotta Facial Plastic Surgery, PC (Marotta Plastic Surgery Specialists)
• Andrew Marotta, RN
• James Christopher Marotta, MD
• Carlos C Marrero Prats, M.D.
• John Marrero, RN

• Specialist in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.