Kathy Shaobing Tan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

233820 Issued in NY

Practice address

5324 7TH Ave
Brooklyn, NY 11220-3121

Phone

(718) 686-6888

Fax

(718) 686-6887

NPI assigned

Mar 8, 2006

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

Other identifiers 1

Other names 1

• Shaobing Tan Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: kathy.tan@ktmo.eclinicaldirectplus.com
• FHIR API: https://fhir4.healow.com/fhir/r4/IJFCAD/Endpoint/IJFCAD

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.

• Huashi Eyewear

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  • NPI 1104298710
  NPD (past)
• Huashi Eyewear

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  • NPI 1326494287
  NPD (past)

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477521409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5324 7TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203121",
            "telephone_number": "718-686-6888",
            "fax_number": "718-686-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5324 7TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203121",
            "telephone_number": "718-686-6888",
            "fax_number": "718-686-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "KATHY",
        "middle_name": "SHAOBING",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "233820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02590807",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAOBING",
            "last_name": "TAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Helen Tan
• Jasmine Tan
• Jennifer Tan
• Jia Ming Tan, OTR/L
• Juan Tan
• Kelly Tan
• Kevin Tan
• Laura Tan
• Lei Collette Ong Tan
• Lyla Tan, PHARMD, RPH

• Internal Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Internal Medicine Physician in New York

• 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; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.