Individual provider Active NPI

Rosemarie Cecelia Tan, MD, PHD

  • Neonatal-Perinatal Medicine Physician
  • Lincoln, NE
National Provider Identifier
1700865862
Registry record updated Aug 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
A052356 Issued in CA
Practice address
555 S 70TH St
Lincoln, NE 68510-2462
Phone
(402) 219-7420
NPI assigned
Jan 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X A052356 CA Primary

Addresses

Primary practice location

555 S 70TH St
Lincoln, NE 68510-2462

Mailing address

8055 O St
Suite 300
Lincoln, NE 68510-2564
Phone (402) 421-0904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160329000784 CA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 5092869974

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A052356CAMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrix Medical Group of California, a Professional Corporation Neonatal-Perinatal Medicine Past Accepting new patients
Lincoln Physician Network LLC Past Accepting new patients
The Physician Network Past Accepting new patients

Organizations & group practices 3

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": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250812800000",
    "number": "1700865862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8055 O ST",
            "address_2": "SUITE 300",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102564",
            "telephone_number": "402-421-0904",
            "fax_number": "402-421-0946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S 70TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102462",
            "telephone_number": "402-219-7420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "ROSEMARIE",
        "middle_name": "CECELIA",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-17",
        "last_updated": "2009-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CA",
            "license": "A052356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.