NPIMap

Individual provider Active NPI

Konstantin Tachan, DO

  • Family Medicine Physician
  • Sarasota, FL
National Provider Identifier
1679100887
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS20150 Issued in FL
Practice address
8592 Potter Park Dr
Sarasota, FL 34238-5467
Phone
(941) 921-6618
Fax
(941) 922-0556
NPI assigned
Mar 26, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS20150 FL Primary

Addresses

Primary practice location

8592 Potter Park Dr
Sarasota, FL 34238-5467

Mailing address

8592 Potter Park Dr
Sarasota, FL 34238-5467
Phone (941) 921-6618

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Konstantin.Tachan@img.directbygreenway.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230724003778 FL Practitioner - Family Practice 3971921818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Pacific NW Un of HS, Col of Osteopathic Medicine, 2020
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Nokomis Physical Therapy LLCGroup PAC ID 8628240843, 104 clinicians
Intercoastal Medical Group IncGroup PAC ID 6305730912, 176 clinicians

Practice addresses (Care Compare)

109 Laurel Rd E
Nokomis, FL 34275-5233
Phone (941) 375-8734

8592 Potter Park Dr
Sarasota, FL 34238-5467
Phone (941) 921-6618

Hospital & facility affiliations

  • Empath Home Health Home health agency, Fort Myers, FL, CCN 109786
  • Patients First Home Care LLC Home health agency, Sarasota, FL, CCN 687176
  • Amedisys Home Health Home health agency, Venice, FL, CCN 107522
  • Mederi Caretenders Home health agency, Sarasota, FL, CCN 108171
  • Haven Home Health Care Home health agency, Venice, FL, CCN 687116
  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087
  • Sarasota Memorial Hospital - Venice Hospital, North Venice, FL, CCN 100359

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Intercoastal Medical Group Inc Family Medicine CurrentSince Sep 1, 2023 Accepting new patients

Locations

8592 Potter Park Dr
Sarasota, FL 34238
Phone (941) 921-6618

943 S Beneva Rd
Ste 306
Sarasota, FL 34232
Phone (941) 362-8644

921 S Beneva Rd
Sarasota, FL 34232
Phone (941) 365-7390

Interoperability endpoints

  • Direct secure messaging: konstantin.tachan@img.directbygreenway.com

Organizations & group practices 2

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.

Hospital & facility affiliations 7

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": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1679100887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8592 POTTER PARK DR",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342385467",
            "telephone_number": "941-921-6618",
            "fax_number": "941-922-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8592 POTTER PARK DR",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342385467",
            "telephone_number": "941-921-6618",
            "fax_number": "941-922-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACHAN",
        "first_name": "KONSTANTIN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS20150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Konstantin.Tachan@img.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8592 Potter Park Dr",
            "city": "Sarasota",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342385467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.