NPIMap

Individual provider Active NPI

Michael Angelo Tan, MD

  • Internal Medicine Physician
  • Morristown, TN
National Provider Identifier
1669499208
Registry record updated May 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
33933 Issued in TN
Practice address
854 West 7TH North St
Morristown, TN 37814-3850
Phone
(423) 581-7119
NPI assigned
Jul 17, 2006
Last updated
May 27, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 33933 TN Primary

Addresses

Primary practice location

854 West 7TH North St
Morristown, TN 37814-3850

Mailing address

854 West 7TH North St
Morristown, TN 37814-3850
Phone (423) 581-7119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20110401000736 TN Practitioner - Internal Medicine 5799969515 Practice locations: Morristown, TN

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Champion Physical Therapy LLC HallsGroup PAC ID 1355416306, shared by 4 NPIs, 277 clinicians

Practice addresses (Care Compare)

3106 Circle Dr
White Pine, TN 37890-3306
Phone (865) 674-7454

3614 W Andrew Johnson Hwy
Morristown, TN 37814-3602
Phone (423) 586-9495

854 W 7TH N St
Morristown, TN 37814-3850
Phone (423) 581-7119

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33933TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Life Care Centers of America, Inc. PastSince Aug 1, 2013 Accepting new patients
Life Care Centers of America, Inc. Past Accepting new patients
Life Care Centers of America, Inc. Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Heritage CenterMorristown, TN, CCN 445215 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jul 30, 2013
Mar 7, 2025
Life Care Center of MorristownMorristown, TN, CCN 445314 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 1, 2013
Mar 7, 2025

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 6

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274918400000",
    "number": "1669499208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "854 WEST 7TH NORTH ST",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378143850",
            "telephone_number": "423-581-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "854 WEST 7TH NORTH ST",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378143850",
            "telephone_number": "423-581-7119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "MICHAEL",
        "middle_name": "ANGELO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2010-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "33933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, TN

Sources for this page

Verify at the official NPI Registry.