Individual provider Active NPI

Sandy Mykim Tang, APRN

  • Nurse Practitioner
  • Miami, FL
National Provider Identifier
1417642075
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11025260 Issued in FL
Practice address
3252 Buena Vista Blvd
Suite 112
Miami, FL 33137
Phone
(786) 396-9680
NPI assigned
Apr 10, 2023
Last updated
Dec 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11025260 FL Primary

Addresses

Primary practice location

3252 Buena Vista Blvd
Suite 112
Miami, FL 33137

Mailing address

12355 SW 125TH CT
Miami, FL 33186-5488

Other practice location 1

6200 SW 73rd St
South Miami, FL 33143-4679
Phone (786) 662-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260116001370 DC Practitioner - Nurse Practitioner 8325525603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
National Center for Plastic Surgery LLCGroup PAC ID 5890984314, 13 clinicians

Practice addresses (Care Compare)

7601 Lewinsville Rd
Suite 400
McLean, VA 22102-2834
Phone (703) 287-8277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11025260FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
National Center for Plastic Surgery LLC CurrentSince Dec 2, 2025 Accepting new patients

Locations

7601 Lewinsville Rd
Ste 400
McLean, VA 22102
Phone (703) 287-8277

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1417642075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12355 SW 125TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331865488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3252 BUENA VISTA BLVD",
            "address_2": "SUITE 112",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33137",
            "telephone_number": "786-396-9680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6200 SW 73rd St",
            "address_purpose": "LOCATION",
            "city": "South Miami",
            "state": "FL",
            "postal_code": "331434679",
            "country_code": "US",
            "telephone_number": "786-662-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANG",
        "first_name": "SANDY",
        "middle_name": "MYKIM",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-10",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11025260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.