Organization Active NPI

Titan Medical Office PC

  • Rehabilitation Clinic/Center
  • Flushing, NY
National Provider Identifier
1538448758
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
License
254139 Issued in NY
Legal business name
TITAN MEDICAL OFFICE PC
Practice address
13620 Maple Ave Ste 802
Flushing, NY 11355-5169
Phone
(347) 438-1534
NPI assigned
Aug 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Authorized official

Name
Dr. Fang Tian, M.D.NPI 1942417902
Title
Physician
Phone
(347) 438-1534

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 254139 NY
Rehabilitation Clinic/Center 261QR0400X 254139 NY Primary

Addresses

Primary practice location

13620 Maple Ave Ste 802
Flushing, NY 11355-5169

Mailing address

342 Kneeland Ave
Yonkers, NY 10704-2713

Other practice location 1

4161 Kissena Blvd Ste E
Flushing, NY 11355-3105
Phone (347) 506-0646

Other identifiers 1

IdentifierTypeStateIssuer
03241485MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120123000846 NY Part B Supplier - Clinic/Group Practice 3072780691 Receives reassigned benefits from 1 practitioner
Practice locations: Flushing, NY

National Provider Directory

National Provider Directory

Locations

13620 Maple Ave
Ste 802
Flushing, NY 11355
Phone (347) 438-1534

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1312416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704153600000",
    "number": "1538448758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 KNEELAND AVE",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107042713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13620 MAPLE AVE STE 802",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555169",
            "telephone_number": "347-438-1534"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4161 Kissena Blvd Ste E",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113553105",
            "country_code": "US",
            "telephone_number": "347-506-0646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TITAN MEDICAL OFFICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-04",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A",
        "authorized_official_last_name": "TIAN",
        "authorized_official_first_name": "FANG",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "347-438-1534",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "254139",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NY",
            "license": "254139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03241485",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.