Active NPI
Corinne Tan, M.D.
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- 2020036060
- Practice address
- 1465 S Grand Blvd
Saint Louis, MO 63104-1003 - Phone
- (314) 268-4180
- NPI assigned
- Jun 11, 2009
- Last updated
- Mar 22, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Surgery Physician | 2086S0120X | 2020036060 | MO | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 2020036060 | MO | Primary |
Addresses
Primary practice location
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Mailing address
1465S. Grand Boulevard
Glennon Hall 5727
Saint Louis, MO 63104
Phone (314) 268-4180
Other practice location 1
545 Barnhill Dr
Emerson Hall 203
Indianapolis, IN 46202-5112
Phone (317) 274-5707
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Thoracic Surgery
- Education
- Saint Louis University School of Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10101 Woodfield LN
Saint Louis, MO 63132-2946
Phone (608) 280-4647
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (314) 577-5641
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020036060 | MO | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Health Care Group | Current | Accepting new patients | |
| SSM Health Care Group | Current | Accepting new patients | |
| SSM Medical Group Inc. | Past | Accepting new patients | |
| SSM Cardinal Glennon Children's Hospital | Past | Accepting new patients |
Locations
10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647
1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070
1465 S Grand Blvd
#5727
Saint Louis, MO 63104
1465 S Grand Blvd
Fl 5
Saint Louis, MO 63104
Phone (314) 577-5334
3635 Vista Ave
Saint Louis, MO 63110
Phone (314) 577-8022
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba SLUCare Physician Group
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1306589544
-
dba SLUCare Physician Group
- Dermatopathology Physician
- Saint Louis, MO
- NPI 1932844495
-
- Children's Hospital
- Saint Louis, MO
- NPI 1508935891
-
dba SSM Health Medical Group
- Durable Medical Equipment & Medical Supplies
- Fenton, MO
- NPI 1124579966
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616371200000",
"number": "1770710105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1465S. GRAND BOULEVARD",
"address_2": "GLENNON HALL 5727",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "63104",
"telephone_number": "314-268-4180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1465 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041003",
"telephone_number": "314-268-4180"
}
],
"practiceLocations": [
{
"address_1": "545 Barnhill Dr",
"address_2": "Emerson Hall 203",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462025112",
"country_code": "US",
"telephone_number": "317-274-5707",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TAN",
"first_name": "CORINNE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-11",
"last_updated": "2021-03-22",
"certification_date": "2021-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0120X",
"taxonomy_group": "",
"desc": "Surgery, Pediatric Surgery",
"state": "MO",
"license": "2020036060",
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "MO",
"license": "2020036060",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.