Active NPI
Godffery R Tang, MD
- Internal Medicine Physician
- Bryn Mawr, PA
National Provider Identifier
1932174257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD059869L
- Practice address
- 130 S Bryn Mawr Ave
Suite H-321
Bryn Mawr, PA 19010-3121 - Phone
- (484) 337-4097
- Fax
- (484) 337-4082
- NPI assigned
- Feb 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD059869L | PA | Primary |
| Hospitalist Physician | 208M00000X | MD059869L | PA |
Addresses
Primary practice location
130 S Bryn Mawr Ave
Suite H-321
Bryn Mawr, PA 19010-3121
Mailing address
130 S Bryn Mawr Ave
Suite H-321
Bryn Mawr, PA 19010-3121
Phone (484) 337-4097
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 232359401 | Other | PA | MAIN LINE HEALTHCARE |
| 001776843 | Medicaid | PA |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Main Line Healthcare | Internal Medicine | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317945600000",
"number": "1932174257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 S BRYN MAWR AVE",
"address_2": "SUITE H-321",
"city": "BRYN MAWR",
"state": "PA",
"postal_code": "190103121",
"telephone_number": "484-337-4097",
"fax_number": "484-337-4082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 S BRYN MAWR AVE",
"address_2": "SUITE H-321",
"city": "BRYN MAWR",
"state": "PA",
"postal_code": "190103121",
"telephone_number": "484-337-4097",
"fax_number": "484-337-4082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANG",
"first_name": "GODFFERY",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-21",
"last_updated": "2011-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MD059869L",
"primary": true
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "PA",
"license": "MD059869L",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAIN LINE HEALTHCARE",
"identifier": "232359401",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001776843",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bryn Mawr, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.