NPIMap

Individual provider Active NPI

Wu Tan, MD

  • Internal Medicine Physician
  • Flushing, NY
National Provider Identifier
1518236181
Registry record updated Sep 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
267436 Issued in NY
Practice address
4235 Main St
Ste 3M
Flushing, NY 11355-3969
Phone
(347) 341-0365
Fax
(718) 886-0644
NPI assigned
Dec 27, 2011
Last updated
Sep 25, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 267436 NY Primary

Addresses

Primary practice location

4235 Main St
Ste 3M
Flushing, NY 11355-3969

Mailing address

2520 146TH St
Flushing, NY 11354-1329
Phone (347) 341-0365

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130702000618 NY Practitioner - Internal Medicine 4486894003 Reassigns benefits to 2 organizations
Practice locations: Flushing, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4235 Main St
Suite 3M
Flushing, NY 11355-3969
Phone (718) 313-2368

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
42.93 of 100Reported as individual
Quality
15
Improvement activities
0
Cost
89.77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Crest Medical Care, PC Internal Medicine CurrentSince Oct 8, 2014 Accepting new patients
Peyman Younesi MD PLLC Internal Medicine CurrentSince Dec 22, 2019 Accepting new patients
Hamilton Park Multicare Past Accepting new patients
Concord Nursing Home, Inc. Past Accepting new patients
Sgrnc LLC Past Accepting new patients
Williamsburg Services LLC Past Accepting new patients

Locations

2830 Pitkin Ave
Brooklyn, NY 11208
Phone (347) 420-8295

11126 Corona Ave
Flushing, NY 11368
Phone (718) 592-6400

4235 Main St
Ste 3M
Flushing, NY 11355
Phone (718) 313-2368

8008 45th Ave
Flushing, NY 11373
Phone (718) 373-0777

Networks

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

Organizations & group practices 6

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506297600000",
    "number": "1518236181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 146TH ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113541329",
            "telephone_number": "347-341-0365",
            "fax_number": "718-886-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 MAIN ST",
            "address_2": "STE 3M",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553969",
            "telephone_number": "347-341-0365",
            "fax_number": "718-886-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "WU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-27",
        "last_updated": "2017-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "267436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.