Individual provider Active NPI

Jiangchuan Tao, MD

  • Clinical Medical Laboratory
  • East Setauket, NY
National Provider Identifier
1679895676
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Practice address
1 Lodge LN
East Setauket, NY 11733-3301
Phone
(631) 965-3750
NPI assigned
Feb 18, 2010
Last updated
Jun 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 265505 NY

Addresses

Primary practice location

1 Lodge LN
East Setauket, NY 11733-3301

Mailing address

1 Lodge LN
East Setauket, NY 11733-3301
Phone (631) 965-3750

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20250627000879 NY Practitioner - Pathology 3779096367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology and Laboratory Consultants of Long Island PLLCGroup PAC ID 0244222115, 20 clinicians

Practice addresses (Care Compare)

100 Port Washington Blvd
St Francis Hospital
Roslyn, NY 11576-1347
Phone (516) 562-6410

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (631) 376-3990

1000 N Village Ave
Mercy Medical Center
Rockville Center, NY 11570-1000
Phone (516) 705-2097

4295 Hempstead Tpke
Bethpage, NY 11714-5713
Phone (516) 520-2374

50 Route 25a
Smithtown, NY 11787-1348
Phone (631) 862-3064

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
265505NYMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology and Laboratory Consultants of Long Island, PLLC Anatomic Pathology & Clinical Pathology CurrentSince Jun 23, 2025 Accepting new patients

Locations

6390 Fly Rd
East Syracuse, NY 13057

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Organizations & group practices 1

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 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": "1266451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1679895676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LODGE LN",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333301",
            "telephone_number": "631-965-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LODGE LN",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333301",
            "telephone_number": "631-965-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAO",
        "first_name": "JIANGCHUAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-18",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "265505",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.