Vickram Jay Tandon, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

291776 Issued in MA

Practice address

476 Jamaicaway Apt 2
Jamaica Plain, MA 02130-2030

Phone

(510) 364-7494

NPI assigned

Jun 23, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1407207145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "476 JAMAICAWAY APT 2",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "476 JAMAICAWAY APT 2",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302030",
            "telephone_number": "510-364-7494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 E Medical Center Drive",
            "address_2": "2128 Taubman Center",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481095340",
            "country_code": "US",
            "telephone_number": "734-998-6022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANDON",
        "first_name": "VICKRAM",
        "middle_name": "JAY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-23",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301110334",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MA",
            "license": "291776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Elizabeth Swanson, D.D.S.
• Judith Sweeney, NP
• Nicole Sweeney
• Khushboo D Talati, DDS
• Cynthia K Tanaka, R.N.
• Helen Tasho, OD
• Kathleen Tata
• Jennifer Taub, PH.D.
• Ehab Tawfils
• Amanda Rashell Taylor

• Plastic Surgery Physician in Jamaica Plain, MA
• Providers in Jamaica Plain, MA by specialty
• Plastic Surgery Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.