Jay Tan, DPT, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01861700 Issued in NJ

Practice address

454 Passaic St
Hackensack, NJ 07601-1519

Phone

(201) 488-7905

Fax

(201) 488-7901

NPI assigned

Oct 21, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bergen Medical Sports and Spine, Inc.Group PAC ID 8022203033, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bergen Medical Sports & Spine, Inc.

  • Sports Medicine (Family Medicine) Physician
  • Paramus, NJ
  • NPI 1962722595
  Medicare reassignment Care Compare group NPD
• Ivyrehab Network Inc.

  • Physical Therapist
  • Hoboken, NJ
  • NPI 1174577274
  Medicare reassignment NPD
• Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC

  • Physical Therapist
  • Great Neck, NY
  • NPI 1841526399
  Medicare reassignment NPD
• Intel PT LLC

  • Physical Medicine & Rehabilitation Physician
  • Paramus, NJ
  • NPI 1275449944
  NPD (past) Authorized official
• At Home by Enhance Therapies LLC

  • Physical Therapist
  • Lakewood, NJ
  • NPI 1124603246
  NPD
• Ivyrehab Network, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Cranford, NJ
  • NPI 1699590265

  Physical Therapist

  NPD
• Access Physical Therapy & Wellness, Inc

  • Physical Therapist
  • Clayton, NC
  • NPI 1881630358
  NPD (past)

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1699179432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 MOTOR PKWY STE 307",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495258",
            "telephone_number": "631-580-5200",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 PASSAIC ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011519",
            "telephone_number": "201-488-7905",
            "fax_number": "201-488-7901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "370 W 58TH ST",
            "address_2": "APT 3H",
            "address_purpose": "LOCATION",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191806",
            "country_code": "US",
            "telephone_number": "510-456-8747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAN",
        "first_name": "JAY",
        "name_prefix": "Mr.",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-21",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "027657-1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01861700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Negar Nora Tabari, DMD
• Dalia A Tadros
• Lillian Rose Tahan
• Elizabeth Tam, M.D.
• Esra Tan
• Jianyou Tan, MD
• Mark E Tanchel, MD
• Amy Tank, PA-C
• Lisa Kaushal Tank, MD
• Mohamed Asem Tantawi, M.D.

• Physical Therapist in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.