Eugene PO Tan, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME66420 Issued in FL

Practice address

8245 County Road 44 Leg a
Suite 2
Leesburg, FL 34788-3751

Phone

(352) 326-3366

Fax

(352) 326-3533

NPI assigned

Feb 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: eugene.tan.1@26900.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/24344/brand/1/csg/1/fhir/r4

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.

• Pediatricians of Florida

  • Pediatrics Physician
  • Leesburg, FL
  • NPI 1619339264
  NPD (past)

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215388800000",
    "number": "1750352258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8245 COUNTY ROAD 44 LEG A",
            "address_2": "SUITE 2",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347883751",
            "telephone_number": "352-326-3366",
            "fax_number": "352-326-3533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8245 COUNTY ROAD 44 LEG A",
            "address_2": "SUITE 2",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347883751",
            "telephone_number": "352-326-3366",
            "fax_number": "352-326-3533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "EUGENE",
        "middle_name": "PO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2008-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME66420",
            "primary": true
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "FL",
            "license": "ME66420",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375528200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David L Sustarsic, M.D.
• Hiba Syed
• Madiha Kashif Syed, M.D
• Steven Sywenki
• Take My Hand Services LLC
• Michael Tan Jr., PA-C
• Vijayakumar Tanjavur, M.D.
• Cedric J Tankson, M.D.
• Taps Transportation LLC
• Target Corporation (Target Pharmacy)

• Pediatrics Physician in Leesburg, FL
• Providers in Leesburg, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.