Sally Que Poa Tan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

19992 Issued in OK

Practice address

1110 N Classen Blvd
Suite 204
Oklahoma City, OK 73106-6843

Phone

(405) 319-1622

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Specialty

Internal Medicine

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Anthony Hospital - Oklahoma City Hospital, Oklahoma City, OK, CCN 370037
• O U Medical Center Hospital, Oklahoma City, OK, CCN 370093
• SSM Health St Anthony Hospital - Shawnee Hospital, Shawnee, OK, CCN 370149
• Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028
• SSM Health St Anthony Hospital - Midwest Hospital, Midwest City, OK, CCN 370094

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Sally Q Tan MD PC

  • Medical Specialty Clinic/Center
  • Oklahoma City, OK
  • NPI 1437456225
  Medicare reassignment NPD Authorized official
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Integris Baptist Medical Center Inc

  • Psychiatric Hospital Unit
  • Oklahoma City, OK
  • NPI 1598837221
  Care Compare affiliation
• Integris Baptist Medical Center Inc

  • Psychiatric Hospital Unit
  • Spencer, OK
  • NPI 1659443372
  Care Compare affiliation
• Integris Baptist Medical Center Inc

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1831103654
  Care Compare affiliation
• Integris Baptist Medical Center Inc

  • Psychiatric Hospital Unit
  • Spencer, OK
  • NPI 1881760759
  Care Compare affiliation
• Ou Medicine Inc.

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1649794157
  Care Compare affiliation
• SSM Health Care of Oklahoma Inc

  • Community/Retail Pharmacy
  • Oklahoma City, OK
  • NPI 1649602293

  Hospital

  Care Compare affiliation
• SSM Health Care of Oklahoma, Inc

  • Ambulance
  • Midwest City, OK
  • NPI 1023603727

  Hospital

  Care Compare affiliation
• SSM Health Care of Oklahoma, Inc

  • General Acute Care Hospital
  • Midwest City, OK
  • NPI 1700471497
  Care Compare affiliation
• SSM Health Care of Oklahoma, Inc.

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1366545311
  Care Compare affiliation
• St Anthony Shawnee Hospital Inc

  • General Acute Care Hospital
  • Shawnee, OK
  • NPI 1134123193
  Care Compare affiliation

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699887331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16804 SHORERUN DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730038431",
            "telephone_number": "405-359-6640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 N CLASSEN BLVD",
            "address_2": "SUITE 204",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731066843",
            "telephone_number": "405-319-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "SALLY",
        "middle_name": "QUE POA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "19992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Tamboli, M.D.
• Tami R Ross, PC
• Tammy Wagstaff, DNP, Aprn-CNP, PLLC
• Amy Tan
• Jeremy F Tan, M.D.
• Danyel Tanaka
• Kenichi Tanaka, M.D.
• Christine Tang
• Clara Lilian Tang, MD
• Mulan Tang

• Internal Medicine Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Internal Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.