NPIMap

Individual provider Active NPI

Jiahuai Tan, M.D.

  • Internal Medicine Physician
  • Mount Vernon, NY
National Provider Identifier
1578891503
Registry record updated Dec 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301095561 Issued in MI
Practice address
12 N 7TH Ave
Mount Vernon, NY 10550-2026
Phone
(914) 664-8000
NPI assigned
Dec 2, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2009

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 4301095561 MI Primary

Addresses

Primary practice location

12 N 7TH Ave
Mount Vernon, NY 10550-2026

Mailing address

7 N 9TH Ave # B1
Mount Vernon, NY 10550-1916

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20130725000854 MS Practitioner - Hematology/Oncology 4082855598 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

830 S Gloster
North Ms Med Ctr Sleep Lab
Tupelo, MS 38801-4934
Phone (662) 377-3258

830 S Gloster St
Tupelo, MS 38801-4934

830 S Gloster St 3Rd FL E Tower
Tupelo, MS 38801-4934

961 S Gloster St
North Mississippi Medical Center Hematology
Tupelo, MS 38801-6343
Phone (662) 377-4550

961 S Gloster St a
N Mississippi Behavioral HLT Ctr Hematology
Tupelo, MS 38801-6343
Phone (662) 377-2964

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301095561MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clay County Medical Corporation Current Accepting new patients
Clay County Medical Corporation CurrentSince Jun 5, 2018 Accepting new patients
North Mississippi Medical Center, Inc CurrentSince Aug 26, 2015 Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Aug 26, 2015 Accepting new patients
Clay County Medical Corporation Current Accepting new patients
North Mississippi Medical Center Current Accepting new patients
Clay County Medical Corporation CurrentSince Jun 5, 2018 Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
Amory Surgery Clinic, PLLC Past Accepting new patients

Locations

1205 Highway 182 W
Starkville, MS 39759
Phone (662) 320-8545

4381 S Eason Blvd
Ste 202
Tupelo, MS 38801
Phone (662) 377-6470

961 S Gloster St
Ste A
Tupelo, MS 38801
Phone (662) 377-2964

961 S Gloster St
Tupelo, MS 38801
Phone (601) 844-9166

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

150 Medical Center Dr
West Point, MS 39773
Phone (601) 494-2321

Interoperability endpoints

  • Direct secure messaging: jiahuaitan@nmhs.medalliesdirect.net

Organizations & group practices 9

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 6

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": "1259712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259712000000",
    "number": "1578891503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 N 9TH AVE # B1",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105501916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 N 7TH AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502026",
            "telephone_number": "914-664-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "JIAHUAI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-02",
        "last_updated": "2009-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301095561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

Verify at the official NPI Registry.