Active NPI
Michelle H Tan, MD
- Internal Medicine Physician
- Gaithersburg, MD
National Provider Identifier
1467411959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- D0060871
- Practice address
- 600 S Frederick Ave
Ste 302
Gaithersburg, MD 20877-1245 - Phone
- (301) 208-1188
- Fax
- (301) 208-1188
- NPI assigned
- Mar 22, 2006
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | D0060871 | MD | Primary |
Addresses
Primary practice location
600 S Frederick Ave
Ste 302
Gaithersburg, MD 20877-1245
Mailing address
12224 Wonder View Way
North Potomac, MD 20878-3750
Phone (240) 994-5657
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 405459800 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary Rutan Hospital | Past | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Osu Internal Medicine, LLC | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
- Family Medicine Physician
- West Liberty, OH
- NPI 1003875949
-
- Internal Medicine Physician
- Columbus, OH
- NPI 1740231448
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258329600000",
"number": "1467411959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12224 WONDER VIEW WAY",
"city": "NORTH POTOMAC",
"state": "MD",
"postal_code": "208783750",
"telephone_number": "240-994-5657",
"fax_number": "301-208-1178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 S FREDERICK AVE",
"address_2": "STE 302",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208771245",
"telephone_number": "301-208-1188",
"fax_number": "301-208-1188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAN",
"first_name": "MICHELLE",
"middle_name": "H",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-03-22",
"last_updated": "2009-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MD",
"license": "D0060871",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "405459800",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.