Ker Shin Tan

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

12 Methuen Street, Beth Israel Lahey Health
3Rd Floor
Lawrence, MA 01840

Phone

(978) 683-3128

NPI assigned

Nov 9, 2020

Last updated

Nov 9, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northeast Behavioral Health Corporation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Beverly, MA
  • NPI 1154302586
  NPD

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1760084438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 METHUEN STREET, BETH ISRAEL LAHEY HEALTH",
            "address_2": "3RD FLOOR",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "01840",
            "telephone_number": "978-683-3128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 METHUEN STREET, BETH ISRAEL LAHEY HEALTH",
            "address_2": "3RD FLOOR",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "01840",
            "telephone_number": "978-683-3128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "KER SHIN",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-09",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tallman Eye Associates, PC (Tallman Eye Steward)
• Tallman Eye Bidco
• Tallman Eye Whittier
• Carter B Tallman, M.D.
• Kristin B Tallman, O.D.
• Ruchee Taneja, DMD
• Ryan Bryce Tarantino, BA
• Michael Tarr, MD
• Nguyet M Tau, D.M.D.
• Bellaliz Tavarez

• Student in an Organized Health Care Education/Training Program in Lawrence, MA
• Providers in Lawrence, MA by specialty
• Student in an Organized Health Care Education/Training Program in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.