Active NPI
Rommel M Tan, PT
- Physical Therapist
- East Elmhurst, NY
National Provider Identifier
1912278516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 025979
- Practice address
- 3223 91St Street
Apt. C105
East Elmhurst, NY 11369 - Phone
- (347) 658-4854
- NPI assigned
- Jan 13, 2012
- Last updated
- Jan 13, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 025979 | NY | Primary |
Addresses
Primary practice location
3223 91St Street
Apt. C105
East Elmhurst, NY 11369
Mailing address
3223 91St Street
Apt. C105
East Elmhurst, NY 11369
Phone (347) 658-4854
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025979 | NY | MD | Clinical Psychologist |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326412800000",
"number": "1912278516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3223 91ST STREET",
"address_2": "APT. C105",
"city": "EAST ELMHURST",
"state": "NY",
"postal_code": "11369",
"telephone_number": "347-658-4854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3223 91ST STREET",
"address_2": "APT. C105",
"city": "EAST ELMHURST",
"state": "NY",
"postal_code": "11369",
"telephone_number": "347-658-4854"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAN",
"first_name": "ROMMEL",
"middle_name": "M",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-01-13",
"last_updated": "2012-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "025979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Elmhurst, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.