NPIMap

Individual provider Active NPI

Xin Yee Tan, MD

  • Nephrology Physician
  • Kingman, AZ
National Provider Identifier
1629599907
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
64464 Issued in AZ
Practice address
2501 N Stockton Hill Rd Ste 102
Kingman, AZ 86401-4140
Phone
(928) 681-2772
Fax
(928) 681-2833
NPI assigned
Jun 27, 2017
Last updated
Jul 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 64464 AZ Primary

Addresses

Primary practice location

2501 N Stockton Hill Rd Ste 102
Kingman, AZ 86401-4140

Mailing address

3333 E Camelback Rd Ste 180
Phoenix, AZ 85018-2396
Phone (602) 997-0484

Other identifiers 1

IdentifierTypeStateIssuer
123253MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20220420001178 AZ Practitioner - Nephrology 9931520566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Akdhc LLCGroup PAC ID 8123912136, 125 clinicians

Practice addresses (Care Compare)

2501 N Stockton Hill Rd
Suite 102
Kingman, AZ 86401-4140
Phone (928) 681-2772

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.2 of 100Reported as group
Quality
67.68
Promoting interoperability
100
Improvement activities
40
Cost
76.33

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64464AZMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Akdhc, LLC Nephrology Current Accepting new patients
Akdhc Surgery Center, LLC Nephrology Current Accepting new patients
Akdhc, LLC Nephrology CurrentSince Apr 5, 2022 Accepting new patients
Akdhc, LLC Nephrology CurrentSince Apr 5, 2022 Accepting new patients

Locations

2771 Silver Creek Rd
Ste 120
Bullhead City, AZ 86442
Phone (928) 763-7722

2501 N Stockton Hill Rd
Ste 102
Kingman, AZ 86401
Phone (928) 681-2772

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

1851 Mesquite Ave
Ste 216
Lk Havasu Cty, AZ 86403
Phone (928) 854-5358

3320 N 2nd St
Phoenix, AZ 85012
Phone (602) 200-8288

3333 E Camelback Rd
Ste 180
Phoenix, AZ 85018
Phone (602) 997-0484

Interoperability endpoints

  • Direct secure messaging: xin.yee.tan.1@11625.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1629599907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 E CAMELBACK RD STE 180",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182396",
            "telephone_number": "602-997-0484",
            "fax_number": "602-943-1453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N STOCKTON HILL RD STE 102",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864014140",
            "telephone_number": "928-681-2772",
            "fax_number": "928-681-2833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "XIN YEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-27",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AZ",
            "license": "64464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123253",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingman, AZ

Sources for this page

Verify at the official NPI Registry.