Organization Active NPI

Wei Yan Tan Physician. P.C.

  • Internal Medicine Physician
  • Woodbury, NY
National Provider Identifier
1649600651
Registry record updated Nov 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
225855 Issued in NY
Legal business name
WEI YAN TAN PHYSICIAN. P.C.
Practice address
281 Syosset Woodbury Rd
Woodbury, NY 11797-1205
Phone
(917) 334-2922
NPI assigned
Nov 13, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2013

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

Authorized official

Name
Weiyan Tan, MD
Title
Ceo
Phone
(917) 334-2922

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 225855 NY Primary

Addresses

Primary practice location

281 Syosset Woodbury Rd
Woodbury, NY 11797-1205

Mailing address

281 Syosset Woodbury Rd
Woodbury, NY 11797-1205
Phone (917) 334-2922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140819001968 NY Part B Supplier - Clinic/Group Practice 8426275215 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

5618 7th Ave
Brooklyn, NY 11220
Phone (718) 439-3284

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DGCJCA

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1384300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385078400000",
    "number": "1649600651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 SYOSSET WOODBURY RD",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117971205",
            "telephone_number": "917-334-2922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 SYOSSET WOODBURY RD",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117971205",
            "telephone_number": "917-334-2922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEI YAN TAN PHYSICIAN. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-13",
        "last_updated": "2013-11-22",
        "status": "A",
        "authorized_official_last_name": "TAN",
        "authorized_official_first_name": "WEIYAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "917-334-2922",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "225855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.