NPIMap

Individual provider Active NPI

Shan Tang, MD

  • Otolaryngology Physician
  • Fayetteville, NC
National Provider Identifier
1790001758
Registry record updated Jul 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
201500826 Issued in NC
Practice address
1839 Quiet CV
Fayetteville, NC 28304-3857
Phone
(910) 323-1463
Fax
(910) 323-1575
NPI assigned
Apr 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Otolaryngology Physician 207Y00000X 201500826 NC Primary

Addresses

Primary practice location

1839 Quiet CV
Fayetteville, NC 28304-3857

Mailing address

1839 Quiet CV
Fayetteville, NC 28304-3857
Phone (910) 323-1463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150720000158 NC Practitioner - Otolaryngology 9830402940 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Johns Hopkins University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fayetteville Otolaryngology Head and Neck Surgery P.a.Group PAC ID 2163421520, 7 clinicians
MCPC-28, LLCGroup PAC ID 2163929175, 8 clinicians

Practice addresses (Care Compare)

1839 Quiet CV
Fayetteville, NC 28304-3857
Phone (910) 323-1463

Hospital & facility affiliations

  • Firsthealth Moore Regional Hospital Hospital, Pinehurst, NC, CCN 340115
  • Cape Fear Valley Medical Center Hospital, Fayetteville, NC, CCN 340028
  • Highsmith Rainey Memorial Hospital Long-term care hospital, Fayetteville, NC, CCN 342014

Merit-based Incentive Payment System (MIPS)

Final score
92.89 of 100Reported as individual
Quality
88.17
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201500826NCMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCPC-28, LLC Otolaryngology CurrentSince Sep 29, 2025 Accepting new patients
Fayetteville Otolaryngology Head and Neck Surgery P.a. Otolaryngology CurrentSince Jul 1, 2015 Accepting new patients

Locations

1839 Quiet Cv
Fayetteville, NC 28304
Phone (910) 323-1463

Interoperability endpoints

  • Direct secure messaging: shantang@fo.allscriptsdirect.net
  • Direct secure messaging: stang128334@firsthealth.direct-ci.net

Organizations & group practices 2

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.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436313600000",
    "number": "1790001758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 QUIET CV",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043857",
            "telephone_number": "910-323-1463",
            "fax_number": "910-323-1575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 QUIET CV",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043857",
            "telephone_number": "910-323-1463",
            "fax_number": "910-323-1575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANG",
        "first_name": "SHAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-15",
        "last_updated": "2015-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NC",
            "license": "201500826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.