Amil Kusain Tan Jr., PHD, RN, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

354353 Issued in NY

Practice address

5718 Woodside Ave Ste 101
Woodside, NY 11377-3400

Phone

(917) 633-7710

NPI assigned

Jun 5, 2024

Sex

Male

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

Doctor of Philosophy, Registered Nurse

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.

• Alicia Almendral MD PLLC

  • Family Medicine Physician
  • Bronx, NY
  • NPI 1083930945
  Medicare reassignment NPD

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1467293126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5718 WOODSIDE AVE STE 101",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5718 WOODSIDE AVE STE 101",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773400",
            "telephone_number": "917-633-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "AMIL KUSAIN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHD, RN, FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "354353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dyoceline N Sykaras
• Synapse Medical Care, P.C.
• Brenda Sze, DDS
• Luisa Fernanda Tabares
• Marcelo Taborga, M.D.
• Serafin Andaya Tapia, OTA/L
• Elaine Renee Taylor, C.A.S.A.C.-T.
• Tazmi Corp
• Susana D Tedjasendjaja
• Anna C Tello

• Family Nurse Practitioner in Woodside, NY
• Providers in Woodside, 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 Jun 5, 2024; 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.