Individual provider Active NPI

Marco Marzan Tan, M.D.

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1871703975
Registry record updated May 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
253740 Issued in NY
Practice address
622 W 168TH St
PH 1-137
New York, NY 10032-3720
Phone
(212) 305-2995
Fax
(212) 305-6792
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 253740 NY Primary
Emergency Medicine Physician 207P00000X 4301088661 MI

Addresses

Primary practice location

622 W 168TH St
PH 1-137
New York, NY 10032-3720

Mailing address

622 W 168TH St
PH 1-137
New York, NY 10032-3720
Phone (212) 305-2995

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
I20090909000038 NY Practitioner - Emergency Medicine 2365597739 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Care Services of New York PCGroup PAC ID 3678678646, 43 clinicians

Practice addresses (Care Compare)

121 Dekalb Ave
Brooklyn, NY 11201-5425
Phone (718) 250-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301088661MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Care Services of New York, P.C. Emergency Medicine CurrentSince Mar 1, 2021 Accepting new patients
Trustees of Columbia University in the City of New York Emergency Medicine CurrentSince Dec 13, 2016 Accepting new patients
Fpa Hospital Based CurrentSince May 1, 2015 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Dec 13, 2016 Accepting new patients
Fpa Hospital Based Current Accepting new patients
Fpa Hospital Based Emergency Medicine CurrentSince May 1, 2015 Accepting new patients

Locations

121 DeKalb Ave
Brooklyn, NY 11201
Phone (718) 250-6604

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

622 W 168th St
Ph 1137
New York, NY 10032
Phone (212) 305-2575

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

Networks

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

Interoperability endpoints

  • Direct secure messaging: mtan1319056@nychhc.direct-ci.com
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 6

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337817600000",
    "number": "1871703975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "address_2": "PH 1-137",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "address_2": "PH 1-137",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-2995",
            "fax_number": "212-305-6792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "MARCO",
        "middle_name": "MARZAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2012-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "253740",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301088661",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.