Stephanie Tan

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F339427-1 Issued in NY

Practice address

4209 47TH Ave Apt 5E
Sunnyside, NY 11104-3032

Phone

(917) 476-4864

NPI assigned

Jul 1, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Icahn School of Medicine at Mount Sinai

  • Neurological Surgery Physician
  • New York, NY
  • NPI 1497029581
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466
  NPD

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1447633904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4209 47TH AVE APT 5E",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111043032",
            "telephone_number": "917-476-4864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4209 47TH AVE APT 5E",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111043032",
            "telephone_number": "917-476-4864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F339427-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunnyside Medical Practice PC
• Sunnyside Optometry P.C.
• Sunnyside Orthodontics
• Sunnyside Pediatric Endocrinology, PC
• Survival Kids
• Sheri Taylor, OTR
• Sepideh Toloue, DMD
• Crystal Eudaliza Toribio, PHARMD
• Milcah Bravo Torralba, OT
• Nyima Tsering, RN

• Family Nurse Practitioner in Sunnyside, NY
• Providers in Sunnyside, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; 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.