Individual provider Active NPI

Allison Leigh Tan, M.D.

  • Vascular & Interventional Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1942521505
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
MD447235 Issued in PA
Practice address
111 S. 11TH Street
Suite 3390
Philadelphia, PA 19107-4824
Phone
(215) 955-2900
Fax
(215) 923-1562
NPI assigned
Jun 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 25MA09780200 NJ
Vascular & Interventional Radiology Physician 2085R0204X MD447235 PA Primary
Diagnostic Radiology Physician 2085R0202X MD447235 PA

Addresses

Primary practice location

111 S. 11TH Street
Suite 3390
Philadelphia, PA 19107-4824

Mailing address

111 S. 11TH Street
Suite 3390
Philadelphia, PA 19107-4824
Phone (215) 955-2900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160708000604 PA Practitioner - Diagnostic Radiology 5890918585 Reassigns benefits to 3 organizations
I20201216002970 NJ Practitioner - Diagnostic Radiology 5890918585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Albert Einstein College of Medicine of Yeshiva University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians
Jefferson University Radiology Associates LLCGroup PAC ID 7315845708, shared by 3 NPIs, 110 clinicians

Practice addresses (Care Compare)

111 S 11TH St
Suite 8490
Philadelphia, PA 19107-4824
Phone (215) 955-6161

850 Walnut St
Philadelphia, PA 19107-5109

999 Route 73 N 101
Jefferson Outpatient Imaging
Marlton, NJ 08053-1227
Phone (856) 424-2929

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09780200NJMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Group of Abington PC Diagnostic Radiology CurrentSince Aug 15, 2016 Accepting new patients
Jefferson University Radiology Associates, LLC Diagnostic Radiology Current Accepting new patients
Jefferson University Radiology Associates, LLC Diagnostic Radiology CurrentSince Aug 1, 2017 Accepting new patients
Jefferson University Radiology Associates LLC Diagnostic Radiology Current Accepting new patients
Jefferson University Physicians Diagnostic Radiology CurrentSince Jul 1, 2017 Accepting new patients
Jefferson University Radiology Associates, LLC Diagnostic Radiology CurrentSince Aug 1, 2017 Accepting new patients
Jefferson University Radiology Associates, LLC Diagnostic Radiology CurrentSince Aug 26, 2020 Accepting new patients

Locations

999 Route 73 N
Ste 101
Marlton, NJ 08053
Phone (856) 424-2929

243 Hurffville Crosskeys Rd
Sewell, NJ 08080
Phone (609) 680-9263

1200 York Rd
Abington, PA 19001
Phone (215) 481-2222

111 S 11th St
Ste 3390
Philadelphia, PA 19107
Phone (215) 955-2900

850 Walnut St
Philadelphia, PA 19107
Phone (215) 503-4900

111 S 11th St
Philadelphia, PA 19107
Phone (215) 955-6161

111 S 11th St
Ste 8490
Philadelphia, PA 19107
Phone (215) 955-6161

900 Walnut St
Fl 2
Philadelphia, PA 19107
Phone (215) 955-1234

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 7

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 1

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": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1942521505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S. 11TH STREET",
            "address_2": "SUITE 3390",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-2900",
            "fax_number": "215-923-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S. 11TH STREET",
            "address_2": "SUITE 3390",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-2900",
            "fax_number": "215-923-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "ALLISON",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-17",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NJ",
            "license": "25MA09780200",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "PA",
            "license": "MD447235",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD447235",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.