Individual provider Active NPI

Himat Tank, M.D.

  • Pediatrics Physician
  • Santa Maria, CA
National Provider Identifier
1396761003
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A35478 Issued in CA
Practice address
1505 Shepard Dr Ste 102
Santa Maria, CA 93454-7016
Phone
(805) 928-9300
Fax
(805) 928-9790
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A35478 CA Primary

Addresses

Primary practice location

1505 Shepard Dr Ste 102
Santa Maria, CA 93454-7016

Mailing address

1505 Shepard Dr Ste 102
Santa Maria, CA 93454-7016
Phone (805) 928-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A35478CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1396761003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 SHEPARD DR STE 102",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934547016",
            "telephone_number": "805-928-9300",
            "fax_number": "805-928-9790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 SHEPARD DR STE 102",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934547016",
            "telephone_number": "805-928-9300",
            "fax_number": "805-928-9790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANK",
        "first_name": "HIMAT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A35478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.