Individual provider Active NPI

Jenny Tang - Chan, M.D.

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1407899867
Registry record updated Sep 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
210935-1 Issued in NY
Practice address
15 W 65TH St
New York, NY 10023-6601
Phone
(212) 769-6313
Fax
(212) 769-7825
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 210935-1 NY Primary

Addresses

Primary practice location

15 W 65TH St
New York, NY 10023-6601

Mailing address

7814 Colonial Rd
Brooklyn, NY 11209-3516
Phone (917) 365-8083

Other names 1

  • Dr. Jenny Tang Professional name

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
I20070228000235 NY Practitioner - Internal Medicine 5294837852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Icahn School of Medicine at Mount Sinai, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
JGB Rehabilitation CorporationGroup PAC ID 5092606533, 13 clinicians

Practice addresses (Care Compare)

250 W 64TH St
New York, NY 10023-6402

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
210935-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
JGB Mental Health & Mental Retardation Services Inc Current Accepting new patients
JGB Rehabilitation Corporation CurrentSince Jan 30, 2013 Accepting new patients

Locations

15 W 65th St
New York, NY 10023
Phone (212) 769-6200

250 W 64th St
Fl 3
New York, NY 10023
Phone (212) 769-6313

250 W 64th St
New York, NY 10023
Phone (212) 769-6247

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: chanj@lighthouseguild.direct.welligent.com
  • Direct secure messaging: jenny.tangchan@jgbmed.eclinicaldirectplus.com

Organizations & group practices 2

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1407899867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7814 COLONIAL RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093516",
            "telephone_number": "917-365-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 W 65TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100236601",
            "telephone_number": "212-769-6313",
            "fax_number": "212-769-7825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANG - CHAN",
        "first_name": "JENNY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "210935-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNY",
            "last_name": "TANG",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.