Takako Tanaka, DDS

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

DS0404707 Issued in PA

Practice address

3400 Civic Center Blvd
4TH Floor, South Pavilion
Philadelphia, PA 19104-5127

Phone

(215) 662-3580

NPI assigned

Oct 28, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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 1

Specialty

Maxillofacial SurgeryAlso: Oral Surgery

Education

University of Detroit Mercy School of Dentistry, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
• Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226
• Good Shepherd Penn Partners Long-term care hospital, Philadelphia, PA, CCN 392050

Merit-based Incentive Payment System (MIPS)

Final score

84.91 of 100Reported as group

Quality

73.58

Promoting interoperability

100

Improvement activities

40

Cost

76.13

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• University of Penn-Medical Group

  • Gynecologic Oncology Physician
  • Philadelphia, PA
  • NPI 1235527342
  Medicare reassignment Care Compare group NPD
• University of Penn-Medical Group

  • Surgery Physician
  • Philadelphia, PA
  • NPI 1780072892
  NPD
• University of Penn-Medical Group

  • Surgical Oncology Physician
  • Philadelphia, PA
  • NPI 1871981985
  NPD
• University of Penn - Medical Group

  • Cardiovascular Disease Physician
  • Philadelphia, PA
  • NPI 1093725145
  NPD (past)

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

• Hospital of the University of PA

  • Ambulatory Fertility Facility
  • Phila, PA
  • NPI 1033262316

  Hospital

  Care Compare affiliation
• Philadelphia Post Acute Partners, LLC

  • Long Term Care Hospital
  • Philadelphia, PA
  • NPI 1427232818

  Long-term care hospital

  Care Compare affiliation
• The Pennsylvania Hospital of the University of Pennsylvania Health Sys

  • General Acute Care Hospital
  • Phila, PA
  • NPI 1063489342
  Care Compare affiliation
• Trustees of the University of Pennsylvania

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1851370910
  Care Compare affiliation

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

{
    "created_epoch": "1256688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1649506577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "4TH FLOOR, SOUTH PAVILION",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-662-3580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "4TH FLOOR, SOUTH PAVILION",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-662-3580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANAKA",
        "first_name": "TAKAKO",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-28",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "PA",
            "license": "DS0404707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yvonna Tan
• Zong Sheng Tan
• Daizo Tanaka, M.D.
• Leeann Tanaka
• Takahide Tanaka, MSW
• Mackenzie Tancredi
• Marcus Tancredi, RPH
• Riya Tandra, DO
• Vandana Tandra
• Srijan Tandukar, MD

• Oral & Maxillofacial Surgery (D.M.D.) in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; 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.