Organization Active NPI

Joshua CH Tan MD Inc

  • Internal Medicine Physician
  • Honolulu, HI
National Provider Identifier
1932166238
Registry record updated Dec 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
7552 Issued in HI
Legal business name
JOSHUA CH TAN MD INC
Practice address
550 S Beretania St
Ste # 608
Honolulu, HI 96813-2414
Phone
(808) 949-8988
Fax
(808) 538-1920
NPI assigned
Apr 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2014

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

Authorized official

Name
Joshua CH Tan, MDNPI 1922297845
Title
President of the Corporation
Phone
(808) 949-8988

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 7552 HI Primary

Addresses

Primary practice location

550 S Beretania St
Ste # 608
Honolulu, HI 96813-2414

Mailing address

550 S Beretania St
Ste # 608
Honolulu, HI 96813-2496
Phone (808) 949-8988

Other identifiers 2

IdentifierTypeStateIssuer
GW054AOtherPTAN
07096001MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130115000431 HI Part B Supplier - Clinic/Group Practice 8224281621 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory

Locations

1451 S King St
Ste 405
Honolulu, HI 96814
Phone (808) 949-8988

1481 S King St
Ste 320
Honolulu, HI 96814
Phone (808) 949-8988

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419984000000",
    "number": "1932166238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S BERETANIA ST",
            "address_2": "STE # 608",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132496",
            "telephone_number": "808-949-8988",
            "fax_number": "808-538-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S BERETANIA ST",
            "address_2": "STE # 608",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132414",
            "telephone_number": "808-949-8988",
            "fax_number": "808-538-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSHUA CH TAN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2014-12-31",
        "status": "A",
        "authorized_official_last_name": "TAN",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "CH",
        "authorized_official_title_or_position": "PRESIDENT OF THE CORPORATION",
        "authorized_official_telephone_number": "808-949-8988",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "7552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "GW054A",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07096001",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.