Active NPI
Patricia Alyssa Maglasang Tan, PT
- Physical Therapist
- Bradenton, FL
National Provider Identifier
1588320105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 163686
- Practice address
- 5927 53Rd LN E
Bradenton, FL 34203-6313 - Phone
- (347) 554-3078
- NPI assigned
- Nov 9, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 163686 | FL | Primary |
Addresses
Primary practice location
5927 53Rd LN E
Bradenton, FL 34203-6313
Mailing address
5927 53Rd LN E
Bradenton, FL 34203-6313
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| T500-673-92-567-0 | Other | FL | DRIVER'S LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 163686 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636416000000",
"number": "1588320105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5927 53RD LN E",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342036313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5927 53RD LN E",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342036313",
"telephone_number": "347-554-3078"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAN",
"first_name": "PATRICIA ALYSSA",
"middle_name": "MAGLASANG",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-09",
"last_updated": "2021-11-09",
"certification_date": "2021-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "163686",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER'S LICENSE",
"identifier": "T500-673-92-567-0",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.