Sarady Tan, M.D., M.S., M.P.H.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G79601 Issued in CA

Practice address

1060 W Perimeter Rd
JB Andrews, MD 20762-6602

Phone

(703) 697-3255

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Family Practice

Education

Oregon Health Sciences University School of Medicine, 1993

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Science

State licenses

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.

• Coquille Indian Tribe

  • Clinic/Center
  • Coos Bay, OR
  • NPI 1376592287
  Medicare reassignment

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1497774319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 W PERIMETER RD",
            "city": "JB ANDREWS",
            "state": "MD",
            "postal_code": "207626602",
            "telephone_number": "703-697-3255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 W PERIMETER RD",
            "city": "JB ANDREWS",
            "state": "MD",
            "postal_code": "207626602",
            "telephone_number": "703-697-3255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "340 MAGNOLIA CIRCLE",
            "address_2": "ATTN: CREDENTIALS",
            "address_purpose": "LOCATION",
            "city": "TYNDALL AFB",
            "state": "FL",
            "postal_code": "32444",
            "country_code": "US",
            "telephone_number": "850-283-7718",
            "fax_number": "850-283-7795",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Wilford Hall Loop Bldg 4554",
            "address_purpose": "LOCATION",
            "city": "Jbsa Lackland",
            "state": "TX",
            "postal_code": "782365638",
            "country_code": "US",
            "telephone_number": "210-292-3440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAN",
        "first_name": "SARADY",
        "credential": "M.D., M.S., M.P.H.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "CA",
            "license": "G79601",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "CA",
            "license": "G79601",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G79601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul A Smith, D.D.S.
• Yost T Smith II, D.M.D.
• Esther Solano
• Kourtni Starkey, M.D.
• Patricia Szmuc, PHARMD, BCPS
• Betsy W Tang, MD
• Phyllis Gail Taylor, LCSW
• Jennifer Caso Tolliver, PSY.D.
• Danielle Anne Touma, MD
• Heather Tropiano, PSY.D.

• Family Medicine Physician in JB Andrews, MD
• Providers in JB Andrews, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.
• 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.