Individual provider Active NPI

Jin Bo Tang, MD

  • Surgery of the Hand (Surgery) Physician
  • Providence, RI
National Provider Identifier
1811255326
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery of the Hand (Surgery) PhysicianTaxonomy code 2086S0105X
License
MD18362 Issued in RI
Practice address
593 Eddy St
Providence, RI 02903-4923
Phone
(401) 444-5871
NPI assigned
May 3, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery of the Hand (Surgery) Physician 2086S0105X MD18362 RI Primary

Addresses

Primary practice location

593 Eddy St
Providence, RI 02903-4923

Mailing address

593 Eddy St
Pob 442a
Providence, RI 02903-4923

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20120912000116 RI Practitioner - Hand SurgeryPractitioner - Plastic and Reconstructive Surgery 9537317862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hand SurgeryAlso: Plastic and Reconstructive Surgery
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

164 Summit Ave
Providence, RI 02906-2853

185 A High Service Ave
North Providence, RI 02904-5114
Phone (401) 354-6050

185 High Service Ave
North Providence, RI 02904-5114
Phone (401) 354-6050

593 Eddy St
Providence, RI 02903-4923

593 Eddy St Apc
Suite 6
Providence, RI 02903-4923
Phone (401) 793-9172

593 Eddy St George BLDG 1St Floor
Providence, RI 02903-4923
Phone (401) 793-9166

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD18362RIMDSurgery of the Hand (Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Corporation Current Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Mar 29, 2015 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Mar 29, 2015 Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients

Locations

950 Warren Ave
Ste 103
East Providence, RI 02914
Phone (401) 606-4325

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

235 Plain St
Ste 203
Providence, RI 02905
Phone (401) 444-2701

593 Eddy St
Providence, RI 02903

235 Plain St
Ste 501
Providence, RI 02905
Phone (401) 277-0701

Interoperability endpoints

  • Direct secure messaging: jtang12255@brownhealth.medalliesdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1811255326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "POB 442A",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-5871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANG",
        "first_name": "JIN",
        "middle_name": "BO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-03",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "RI",
            "license": "MD18362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.