Active NPI
Sandy Mykim Tang, APRN
- Nurse Practitioner
- Miami, FL
National Provider Identifier
1417642075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 11025260
- Practice address
- 3252 Buena Vista Blvd
Suite 112
Miami, FL 33137 - Phone
- (786) 396-9680
- NPI assigned
- Apr 10, 2023
- Last updated
- Dec 22, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11025260 | FL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| National Center for Plastic Surgery LLC | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.