NPIMap

Individual provider Active NPI

Edison N Tan, M.D.

  • Internal Medicine Physician
  • Clearwater, FL
National Provider Identifier
1962475533
Registry record updated Feb 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME78501 Issued in FL
Practice address
1840 N Highland Ave
Clearwater, FL 33755-2138
Phone
(727) 442-3001
Fax
(727) 467-9106
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME78501 FL Primary

Addresses

Primary practice location

1840 N Highland Ave
Clearwater, FL 33755-2138

Mailing address

1840 N Highland Ave
Clearwater, FL 33755-2138
Phone (727) 442-3001

Other identifiers 1

IdentifierTypeStateIssuer
49390OtherBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061218000242 FL Practitioner - Internal Medicine 7416956628 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Med Center of Clearwater IncGroup PAC ID 2264413152, 6 clinicians

Practice addresses (Care Compare)

1840 N Highland Ave
Clearwater, FL 33755-2138
Phone (727) 442-3001

Hospital & facility affiliations

  • Baycare Home Care Inc Home health agency, Dunedin, FL, CCN 107415
  • Morton Plant Hospital Hospital, Clearwater, FL, CCN 100127
  • Mease Countryside Hospital Hospital, Safety Harbor, FL, CCN 100265
  • Mease Dunedin Hospital Hospital, Dunedin, FL, CCN 100043
  • Morton Plant Rehabilitation Center Nursing home, Belleair, FL, CCN 105128
  • Belleair Health Care Center Nursing home, Clearwater, FL, CCN 105636

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Medical Arts, PA Internal Medicine CurrentSince Apr 1, 2017 Accepting new patients
Florida Med Center of Clearwater Inc Internal Medicine CurrentSince Sep 24, 2006 Accepting new patients
Florida Med Center Countryside Internal Medicine Past Accepting new patients
Optumcare Florida, LLC Past Accepting new patients

Locations

1840 N Highland Ave
Clearwater, FL 33755
Phone (727) 442-3001

2595 Tampa Rd
Ste M
Palm Harbor, FL 34684
Phone (727) 772-8007

Interoperability endpoints

  • Direct secure messaging: edison.tan@fmcoc.eclinicaldirectplus.com

Organizations & group practices 4

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 6

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202083200000",
    "number": "1962475533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 N HIGHLAND AVE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337552138",
            "telephone_number": "727-442-3001",
            "fax_number": "727-467-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 N HIGHLAND AVE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337552138",
            "telephone_number": "727-442-3001",
            "fax_number": "727-467-9106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "EDISON",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2008-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME78501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "49390",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.