Vivian V Tan, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R164835 Issued in MD

Practice address

6480 Old Waterloo Rd
Elkridge, MD 21075

Phone

(410) 799-0291

NPI assigned

Jan 5, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Vivian C Valdez Former name

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Synergy Medical Group LLCGroup PAC ID 0749644177, 102 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ms_vtan6@landmarkhealth-direct.org

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.

• Regenwell Wound Specialty Group - Central MD, LLC

  • Family Medicine Physician
  • Towson, MD
  • NPI 1194540484
  Medicare reassignment NPD Authorized official
• Synergy Medical Group LLC

  • Internal Medicine Physician
  • Lutherville, MD
  • NPI 1912736901
  Medicare reassignment Care Compare group
• Angel Hands Healthcare Services, LLC

  • Health Service Clinic/Center
  • Baltimore, MD
  • NPI 1902318124
  Medicare reassignment NPD
• Landmark Medical of Tennessee PC

  • General Practice Physician
  • Annapolis, MD
  • NPI 1922722172
  Medicare reassignment NPD
• Synergy Medical Group LLC

  • Vascular Surgery Physician
  • Timonium, MD
  • NPI 1679363089

  DC

  Medicare reassignment
• Synergy Medical Group LLC

  • Nephrology Physician
  • Baltimore, MD
  • NPI 1154297455
  NPD
• Synergy Medical Group LLC

  • Nephrology Physician
  • Hagerstown, MD
  • NPI 1881564979
  NPD
• Landmark Medical of Tennessee PC

  • General Practice Physician
  • Westbrook, ME
  • NPI 1982310439
  NPD

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

{
    "created_epoch": "1515110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1649787011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6480 OLD WATERLOO RD",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756508",
            "telephone_number": "410-799-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6480 OLD WATERLOO RD",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "21075",
            "telephone_number": "410-799-0291"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4155 Glen Park Rd",
            "address_purpose": "LOCATION",
            "city": "Nottingham",
            "state": "MD",
            "postal_code": "212361019",
            "country_code": "US",
            "telephone_number": "410-248-0661",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1910 Towne Centre Blvd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Annapolis",
            "state": "MD",
            "postal_code": "214013599",
            "country_code": "US",
            "telephone_number": "657-237-2450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAN",
        "first_name": "VIVIAN",
        "middle_name": "V",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-05",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R164835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIVIAN",
            "last_name": "VALDEZ",
            "middle_name": "C",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Susan S. McLaughlin, M.D., P.C
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• Mary Theresa Sybrant, NP-C
• Lori Nichelle Sydnor
• Robert Tanwani, HHA
• Barry Steven Tatar, M.D.
• Denesha Nyema Tatum-Charles, LMSW
• Debra Jeanne Taylor, P.T.
• Ludmila H. Tchakarova, DDS

• Family Nurse Practitioner in Elkridge, MD
• Providers in Elkridge, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; 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.