Leeann Tanaka

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OSO19093 Issued in PA

Practice address

5000 Woodland Ave
Philadelphia, PA 19143-5137

Phone

(215) 726-9807

Fax

(215) 726-0424

NPI assigned

Apr 16, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Family Practice

Education

Philadelphia College of Osteopathic Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Philadelphia College of Osteopathic MedicineGroup PAC ID 0648179234, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: leeann.tanaka.p1@direct.pcom.nextgenshare.com

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.

• Philadelphia College of Osteopathic Medicine

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1881635704
  Medicare reassignment Care Compare group NPD
• City of Philadelphia

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1942317094
  Medicare reassignment NPD
• City of Philadelphia

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1427165307
  NPD
• City of Philadelphia

  • Clinical Medical Laboratory
  • Phila, PA
  • NPI 1689688798
  NPD
• Philadelphia College of Osteopathic Medicine

  • Clinical Psychologist
  • Philadelphia, PA
  • NPI 1316230220
  NPD (past)

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

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1760801898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S 31ST ST FL 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191463506",
            "telephone_number": "215-925-2400",
            "fax_number": "215-925-9162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 WOODLAND AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191435137",
            "telephone_number": "215-726-9807",
            "fax_number": "215-726-0424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 W 14th St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198011013",
            "country_code": "US",
            "telephone_number": "302-733-1042",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 W 14th St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198011013",
            "country_code": "US",
            "telephone_number": "302-733-1042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANAKA",
        "first_name": "LEEANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-16",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "DE",
            "license": "C2-0012248",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OSO19093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• VI Ean Tan, M.D.
• Ying Hao Tan, OD
• Yvonna Tan
• Zong Sheng Tan
• Daizo Tanaka, M.D.
• Takahide Tanaka, MSW
• Takako Tanaka, DDS
• Mackenzie Tancredi
• Marcus Tancredi, RPH
• Riya Tandra, DO

• Family Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; 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.