Individual provider Active NPI

Branden Tang

  • Physician Assistant
  • Wichita, KS
National Provider Identifier
1609434000
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
027880 Issued in NY
Practice address
10112 E Clark St
Wichita, KS 67207-7747
Phone
(316) 207-4276
NPI assigned
May 31, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 027880 NY Primary
Physician Assistant 363A00000X 1502260 KS

Addresses

Primary practice location

10112 E Clark St
Wichita, KS 67207-7747

Mailing address

10112 E Clark St
Wichita, KS 67207-7747
Phone (316) 207-4276

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220628001630 NY Practitioner - Physician Assistant 4385077833 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1111 Marcus Ave
New Hyde Park, NY 11042-1034

1345 Ave of He Americas
New York, NY 10105

1345 RXR PLZ
Uniondale, NY 11556-1301

15 Grumman Rd W
Suite 1400
Bethpage, NY 11714-3567

179 Ave at the CMN
Suite 214
Shrewsbury, NJ 07702

18 Saratoga Way
Short Hills, NJ 07078-1215

PO
Suite 7928
Philadelphia, PA 19170-0001

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
027880NYMDDental Hygienist
1502260KSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Oct 19, 2022 Accepting new patients
Wyckoff Professional Medical Services, PC CurrentSince Sep 4, 2025 Accepting new patients

Locations

374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485

30 7th Ave
New York, NY 10011
Phone (646) 665-6000

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: branden.tang.1@2983.direct.athenahealth.com
  • Direct secure messaging: btang69479@northwell.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1609434000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10112 E CLARK ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672077747",
            "telephone_number": "316-207-4276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10112 E CLARK ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672077747",
            "telephone_number": "316-207-4276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANG",
        "first_name": "BRANDEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-31",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027880",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "1502260",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.