Individual provider Active NPI

Kan Tun, M.D.

  • Obstetrics & Gynecology Physician
  • Flushing, NY
National Provider Identifier
1700027109
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
252164 Issued in NY
Practice address
131-72 40TH Road
Flushing, NY 11354
Phone
(718) 886-1287
Fax
(718) 886-3903
NPI assigned
Mar 13, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 252164 NY Primary

Addresses

Primary practice location

131-72 40TH Road
Flushing, NY 11354

Mailing address

125 Walker St FL 2
New York, NY 10013-4135
Phone (212) 226-8866

Other practice location 1

13626 37th Ave
Flushing, NY 11354-6533
Phone (718) 886-1287

Other identifiers 1

IdentifierTypeStateIssuer
03108014MedicaidNY

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
I20160519000925 NY Order and Referring Only - Obstetrics/GynecologyPractitioner - Obstetrics/Gynecology 0840473559

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
252164NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Flushing Hospital & Medical Center Past Accepting new patients
Charles B. Wang Community Health Center, Inc. Past Accepting new patients
Charles B. Wang Community Health Center, Inc. Past Accepting new patients
Flushing Hospital & Medical Center Past Accepting new patients

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: ktun787773@direct.ochin.org
  • Direct secure messaging: ktun@1120.direct.myezyaccess.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1236902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1700027109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 WALKER ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134135",
            "telephone_number": "212-226-8866",
            "fax_number": "212-226-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131-72 40TH ROAD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11354",
            "telephone_number": "718-886-1287",
            "fax_number": "718-886-3903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13626 37th Ave",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113546533",
            "country_code": "US",
            "telephone_number": "718-886-1287",
            "fax_number": "718-886-3903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUN",
        "first_name": "KAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-13",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "252164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03108014",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.