Individual provider Active NPI

Glenn Anthony Tan, M.D.

  • Obstetrics & Gynecology Physician
  • Beloit, WI
National Provider Identifier
1689692410
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
50634 Issued in WI
Practice address
1905 E. Huebbe Parkway
Beloit Health System Inc
Beloit, WI 53511-1842
Phone
(608) 364-2220
Fax
(608) 364-2489
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 50634 WI Primary
Obstetrics & Gynecology Physician 207V00000X 036-119964 IL

Addresses

Primary practice location

1905 E. Huebbe Parkway
Beloit Health System Inc
Beloit, WI 53511-1842

Mailing address

1905 E. Huebbe Parkway
Beloit Health System Inc
Beloit, WI 53511-1842
Phone (608) 364-2220

Other identifiers 1

IdentifierTypeStateIssuer
1689692410MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070808000254 WI Practitioner - Obstetrics/Gynecology 7618971458 Reassigns benefits to 1 organization
I20071210000360 IL Practitioner - Obstetrics/Gynecology 7618971458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beloit Health System IncGroup PAC ID 8224947858, 138 clinicians

Practice addresses (Care Compare)

1735 Madison Rd
Beloit, WI 53511-3216
Phone (608) 363-7510

1905 E Huebbe Pkwy
Beloit, WI 53511-1842
Phone (608) 363-5000

1905 W Hart Rd
Beloit, WI 53511-2230
Phone (608) 364-2200

1969 W Hart Rd
Beloit, WI 53511-2230
Phone (608) 364-5756

Hospital & facility affiliations

  • Beloit Health System Hospital, Beloit, WI, CCN 520100

Merit-based Incentive Payment System (MIPS)

Final score
80.93 of 100Reported as group
Quality
64.82
Promoting interoperability
100
Improvement activities
40
Cost
71.63

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-119964ILMDObstetrics & Gynecology Physician
50634WIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beloit Health System, Inc CurrentSince Jan 1, 2010 Accepting new patients
Beloit Health System Inc Obstetrics & Gynecology Current Accepting new patients
Beloit Health System, Inc CurrentSince Jan 1, 2010 Accepting new patients
Beloit Clinic, S.C. Current Accepting new patients
Beloit Health System Inc Obstetrics & Gynecology CurrentSince Jan 1, 2010 Accepting new patients
Beloit Health System, Inc Past Accepting new patients

Locations

5605 E Rockton Rd
Roscoe, IL 61073
Phone (815) 525-4000

1905 E Huebbe Pkwy
Beloit, WI 53511
Phone (608) 364-2293

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

1735 Madison Rd
Beloit, WI 53511
Phone (608) 363-7510

Organizations & group practices 6

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 1

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1689692410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 E. HUEBBE PARKWAY",
            "address_2": "BELOIT HEALTH SYSTEM INC",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111842",
            "telephone_number": "608-364-2220",
            "fax_number": "608-364-2489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 E. HUEBBE PARKWAY",
            "address_2": "BELOIT HEALTH SYSTEM INC",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111842",
            "telephone_number": "608-364-2220",
            "fax_number": "608-364-2489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "GLENN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "50634",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036-119964",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689692410",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beloit, WI

Sources for this page

Verify at the official NPI Registry.