Mark Tan, M.D.

Primary specialty

Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X

License

A94624 Issued in CA

Practice address

209 Fair Oaks Ave
South Pasadena, CA 91030-1814

Phone

(626) 396-2900

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, CA2 enrollments

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 2

Specialty

Plastic and Reconstructive Surgery

Education

Northwestern University Feinberg Medical School, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of ChicagoGroup PAC ID 7719899426, 1,674 clinicians

The University of Chicago Medical CenterGroup PAC ID 7618880766, 907 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The University of Chicago Medical Center Hospital, Chicago, IL, CCN 140088
• Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213
• Ingalls Memorial Hospital Hospital, Harvey, IL, CCN 140191

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: mtan243485@uchospital.direct-ci.com

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.

• The University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1033218128
  Medicare reassignment Care Compare group NPD
• University of Chicago

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1821048786
  Medicare reassignment Care Compare group NPD
• City of Hope Medical Foundation

  dba City of Hope Duarte

  • Hematology & Oncology Physician
  • Duarte, CA
  • NPI 1871886366
  Medicare reassignment
• City of Hope Medical Group, Inc.

  • Anesthesiology Physician
  • Duarte, CA
  • NPI 1033435292

  Plastic Surgery

  NPD
• The University of Chicago Medical Center

  dba UCMC Pharmacy Services

  • Community/Retail Pharmacy
  • Calumet City, IL
  • NPI 1255895678
  NPD
• California Cancer Specialists Medical Group Inc

  • Anesthesiology Physician
  • Duarte, CA
  • NPI 1912006636

  Plastic Surgery

  NPD (past)
• CHHP Holdings II, LLC

  dba Community Hospital of Huntington Park

  • General Acute Care Hospital
  • Huntington Park, CA
  • NPI 1891059127
  NPD (past)
• Pasadena Hospital Association, LTD.

  dba Huntington Hospital

  • Psychiatric Hospital Unit
  • Pasadena, CA
  • NPI 1437121142
  NPD (past)
• Usc Arcadia Hospital

  • Rehabilitation Hospital Unit
  • Arcadia, CA
  • NPI 1164410593
  NPD (past)
• Advocate Health and Hospitals Corporation

  dba Advocate Good Shepherd Hospital

  • General Acute Care Hospital
  • Barrington, IL
  • NPI 1447368071
  NPD (past)
• Northwest Community Hospital

  dba Endeavor Health Northwest Community Hospital

  • General Acute Care Hospital
  • Arlington Heights, IL
  • NPI 1770531600
  NPD (past)
• Presence Central and Suburban Hospitals Network

  dba Presence St. Joseph Hospital - Elgin Psychiatric Unit

  • Psychiatric Hospital Unit
  • Elgin, IL
  • NPI 1568538387
  NPD (past)

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

• Ingalls Memorial Hospital

  • General Acute Care Hospital
  • Harvey, IL
  • NPI 1598756686
  Care Compare affiliation
• Silver Cross Hospital & Medical Centers

  • Rehabilitation Hospital Unit
  • New Lenox, IL
  • NPI 1003933797
  Care Compare affiliation
• Silver Cross Hospital & Medical Centers

  dba Silver Cross Hospital

  • General Acute Care Hospital
  • New Lenox, IL
  • NPI 1568553519
  Care Compare affiliation
• The University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1508956509
  Care Compare affiliation

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1578658266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 512185",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900510185",
            "telephone_number": "626-775-3514",
            "fax_number": "626-218-5310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 FAIR OAKS AVE",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910301814",
            "telephone_number": "626-396-2900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 W Huntington Dr Ste 400",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "CA",
            "postal_code": "910073471",
            "country_code": "US",
            "telephone_number": "626-218-9840",
            "fax_number": "626-218-9860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 E. Duarte Rd.",
            "address_purpose": "LOCATION",
            "city": "Duarte",
            "state": "CA",
            "postal_code": "91010",
            "country_code": "US",
            "telephone_number": "626-359-8111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAN",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A94624",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A94624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A946240",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@cityofhope.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "CITY OF HOPE MEDICAL FOUNDATION",
            "address_1": "209 Fair Oaks Ave",
            "city": "South Pasadena",
            "state": "CA",
            "country_code": "US",
            "postal_code": "910301814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Ophthalmic Plastic and Reconstructive Surgery Physician in South Pasadena, CA
• Providers in South Pasadena, CA by specialty
• Ophthalmic Plastic and Reconstructive Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; 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.