Jose G. Tandoc, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704207032 Issued in MI

Practice address

2601 Electric Ave
Port Huron, MI 48060-6587

Phone

(810) 985-1500

Fax

(810) 966-3104

NPI assigned

Sep 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Macomb Hospital CorporationGroup PAC ID 7911808381, shared by 5 NPIs, 349 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jtandoc2914@direct.hfhs.org

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.

• Henry Ford Macomb Hospital Corporation

  • Certified Registered Nurse Anesthetist
  • Clinton Township, MI
  • NPI 1528130739

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Henry Ford Macomb Hospital Corporation

  dba Henry Ford Macomb Health Center Chesterfield

  • Nurse Practitioner
  • Chesterfield, MI
  • NPI 1952440521
  Medicare reassignment NPD
• Macomb Anesthesia, PC

  • Anesthesiology Physician
  • Clinton Township, MI
  • NPI 1639248206
  Medicare reassignment NPD
• Henry Ford Macomb Hospital Corporation

  dba Henry Ford Health Macomb Hospital

  • General Acute Care Hospital
  • Clinton TWP, MI
  • NPI 1023114634
  NPD
• Henry Ford Macomb Hospital Corporation

  • Neonatal Nurse Practitioner
  • Clinton Township, MI
  • NPI 1912301094

  Nurse Anesthetist, Certified Registered

  NPD
• Waterford Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Waterford, MI
  • NPI 1467788729
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Macomb Hospital Corporation

  dba Henry Ford Health Macomb Hospital

  • General Acute Care Hospital
  • Clinton TWP, MI
  • NPI 1023114634
  Care Compare affiliation
• Henry Ford Macomb Hospital Corporation

  • General Acute Care Hospital
  • Warren, MI
  • NPI 1902842735
  Care Compare affiliation

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457452294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56432 EDGEWOOD DR",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483165832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 ELECTRIC AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606587",
            "telephone_number": "810-985-1500",
            "fax_number": "810-966-3104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANDOC",
        "first_name": "JOSE",
        "middle_name": "G.",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704207032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "JT207032",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Michelle Szymkowski, LMT
• George E Tache, DDS
• James Michael Talbot
• Tammy Sue Wilson (Resilience Counseling & Play Therapy, LLC)
• Emily Tan, DO
• Hernani S Tansuche, MD
• Lisa Tate, LLMSW
• Andrea Taube
• Sara M Tavora, LMSW
• Breonna Taylor

• Certified Registered Nurse Anesthetist in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Certified Registered Nurse Anesthetist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.