Individual provider Active NPI

Kejian Tang, M.D.

  • Neurology Physician
  • Massena, NY
National Provider Identifier
1568410587
Registry record updated Jan 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
224356-1 Issued in NY
Practice address
181 Maple St
Massena, NY 13662-1012
Phone
(315) 842-3095
Fax
(315) 842-3035
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X E4568 AR
Neurology Physician 2084N0400X 224356-1 NY Primary
Neurology Physician 2084N0400X E-4568 AK

Addresses

Primary practice location

181 Maple St
Massena, NY 13662-1012

Mailing address

1 Hospital Drive
Massena, NY 13662
Phone (315) 769-4200

Other identifiers 1

IdentifierTypeStateIssuer
02281450MedicaidNY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20061103000431 NY Practitioner - Neurology 6103856752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massena Hospital IncGroup PAC ID 1456781491, 45 clinicians

Practice addresses (Care Compare)

181 Maple St
Suite a
Massena, NY 13662-1052
Phone (315) 842-3095

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.56 of 100Reported as apm
Quality
87.76
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E4568ARMDSpecialist
E-4568AKMDNeurology Physician
224356-1NYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Massena Hospital, Inc CurrentSince Jan 5, 2020 Accepting new patients
Neurological Assoc of Neny PC Neurology Past Accepting new patients
Davis Brown & Morse Partnership Neurological Associates Specialist Past Accepting new patients

Locations

181 Maple St
Ste C
Massena, NY 13662
Phone (315) 769-1667

1 Hospital Dr
Massena, NY 13662
Phone (315) 764-1711

181 Maple St
Massena, NY 13662
Phone (315) 769-1667

181 Maple St
Ste A
Massena, NY 13662
Phone (315) 769-4704

Interoperability endpoints

  • Direct secure messaging: tanke@hiemail.healtheconnections.org
  • Direct secure messaging: ktang328396@direct.rochesterregional.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1568410587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DRIVE",
            "city": "MASSENA",
            "state": "NY",
            "postal_code": "13662",
            "telephone_number": "315-769-4200",
            "fax_number": "315-769-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 MAPLE ST",
            "city": "MASSENA",
            "state": "NY",
            "postal_code": "136621012",
            "telephone_number": "315-842-3095",
            "fax_number": "315-842-3035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANG",
        "first_name": "KEJIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AR",
            "license": "E4568",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "224356-1",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AK",
            "license": "E-4568",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02281450",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Massena, NY

Sources for this page

Verify at the official NPI Registry.