Individual provider Active NPI

Kendi Tang, DO

  • Family Medicine Physician
  • Carle Place, NY
National Provider Identifier
1861078503
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
319982 Issued in NY
Practice address
393 Old Country Rd Ste 200
Carle Place, NY 11514-2131
Phone
(516) 742-8787
NPI assigned
Mar 23, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 319982 NY Primary

Addresses

Primary practice location

393 Old Country Rd Ste 200
Carle Place, NY 11514-2131

Mailing address

393 Old Country Rd Ste 200
Carle Place, NY 11514-2131
Phone (516) 742-8787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240618000861 NY Practitioner - Family Practice 8325581432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 6709174493, 17 clinicians

Practice addresses (Care Compare)

393 Old Country Rd
Carle Place, NY 11514-2131
Phone (516) 877-0977

Hospital & facility affiliations

  • Tender Loving Care, an Amedisys Company Home health agency, Carle Place, NY, CCN 337143
  • Mount Sinai South Nassau Hospital, Oceanside, NY, CCN 330198

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
319982NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2024 Accepting new patients

Locations

393 Old Country Rd
Carle Place, NY 11514
Phone (516) 877-0977

393 Old Country Rd
Ste 200
Carle Place, NY 11514
Phone (516) 742-8787

8002 Kew Gardens Rd
Ste 323
Kew Gardens, NY 11415
Phone (718) 268-6300

200 Old Country Rd
Ste 520
Mineola, NY 11501
Phone (516) 877-0977

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Organizations & group practices 1

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 2

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": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1861078503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 OLD COUNTRY RD STE 200",
            "city": "CARLE PLACE",
            "state": "NY",
            "postal_code": "115142131",
            "telephone_number": "516-742-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 OLD COUNTRY RD STE 200",
            "city": "CARLE PLACE",
            "state": "NY",
            "postal_code": "115142131",
            "telephone_number": "516-742-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANG",
        "first_name": "KENDI",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-23",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "319982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carle Place, NY

Sources for this page

Verify at the official NPI Registry.