Individual provider Active NPI

Elbert Than Tun, M.D.

  • Internal Medicine Physician
  • Little Neck, NY
National Provider Identifier
1790925774
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A111617 Issued in CA
Practice address
24324 72ND Ave FL 2
Little Neck, NY 11362-2319
Phone
(718) 225-2321
NPI assigned
Mar 3, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A111617 CA Primary

Addresses

Primary practice location

24324 72ND Ave FL 2
Little Neck, NY 11362-2319

Mailing address

24324 72ND Ave FL 2
Little Neck, NY 11362-2319
Phone (718) 225-2321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20141222002009 CA Order and Referring Only - Internal MedicinePractitioner - Internal MedicinePractitioner - Geriatric Medicine 9032255104

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
111617CAMDGeneral Practice Dentistry
A111617CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1790925774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24324 72ND AVE FL 2",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113622319",
            "telephone_number": "718-225-2321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24324 72ND AVE FL 2",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113622319",
            "telephone_number": "718-225-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUN",
        "first_name": "ELBERT",
        "middle_name": "THAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-03",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A111617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Neck, NY

Sources for this page

Verify at the official NPI Registry.