Individual provider Active NPI

Hung-Jui Tan, M.D.

  • Urology Physician
  • Los Angeles, CA
National Provider Identifier
1851597587
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
201601278 Issued in NC
Practice address
13075 Pacific Promenade
Apt 409
Los Angeles, CA 90094-2110
Phone
(734) 972-6075
NPI assigned
Jun 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X A123731 CA
Student in an Organized Health Care Education/Training Program 390200000X 4301090540 MI
Urology Physician 208800000X 201601278 NC Primary

Addresses

Primary practice location

13075 Pacific Promenade
Apt 409
Los Angeles, CA 90094-2110

Mailing address

13075 Pacific Promenade
Apt 409
Los Angeles, CA 90094-2110
Phone (734) 972-6075

Other names 1

  • Ray Tan Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address htan180252@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20161010001288 NC Practitioner - Urology 0840424495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Michigan Medical School, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of North Carolina at Chapel HillGroup PAC ID 0648181156, 2,028 clinicians

Practice addresses (Care Compare)

101 Manning Dr
Chapel Hill, NC 27514-4220
Phone (984) 974-1000

Hospital & facility affiliations

  • Unc Hospitals Hospital, Chapel Hill, NC, CCN 340061
  • Rex Hospital Hospital, Raleigh, NC, CCN 340114
  • Unc Health Nash Hospital, Rocky Mount, NC, CCN 340147

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A123731CAMDUrology Physician
201601278NCMDUrology Physician
4301090540MIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina at Chapel Hill CurrentSince Jul 31, 2016 Accepting new patients
Park Ophthalmology Past Accepting new patients

Locations

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

100 Eastowne Dr
Fl 14
Chapel Hill, NC 27514
Phone (984) 215-5556

460 Waterstone Dr
Hillsborough, NC 27278
Phone (984) 215-2444

430 Waterstone Dr
Hillsborough, NC 27278
Phone (984) 215-2000

2901 Blue Ridge Rd
Raleigh, NC 27607
Phone (919) 784-3105

4420 Lake Boone Trl
Ste 100
Raleigh, NC 27607
Phone (984) 215-6950

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 3

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": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1851597587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13075 PACIFIC PROMENADE",
            "address_2": "APT 409",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900942110",
            "telephone_number": "734-972-6075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13075 PACIFIC PROMENADE",
            "address_2": "APT 409",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900942110",
            "telephone_number": "734-972-6075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "HUNG-JUI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-21",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A123731",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301090540",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "201601278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "htan180252@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "170 Manning Dr",
            "city": "Chapel Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275144221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "RAY",
            "last_name": "TAN",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.