Individual provider Active NPI

Chyne Tan, MD

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1902950611
Registry record updated Feb 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
196566 Issued in NY
Practice address
128 Mott St Ste 301
New York, NY 10013-5575
Phone
(212) 274-1577
NPI assigned
Jan 22, 2007
Last updated
Feb 22, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 196566 NY Primary

Addresses

Primary practice location

128 Mott St Ste 301
New York, NY 10013-5575

Mailing address

128 Mott St Ste 301
New York, NY 10013-5575
Phone (212) 274-1577

Other identifiers 1

IdentifierTypeStateIssuer
196566OtherNYLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1902950611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 MOTT ST STE 301",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100135575",
            "telephone_number": "212-274-1577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 MOTT ST STE 301",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100135575",
            "telephone_number": "212-274-1577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "CHYNE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "196566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "196566",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.