Individual provider Active NPI

Michael J Tan, MD

  • Infectious Disease Physician
  • Akron, OH
National Provider Identifier
1972556413
Registry record updated Jul 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
35-079157 Issued in OH
Practice address
75 Arch St
Ste. 506
Akron, OH 44304-1429
Phone
(330) 375-3894
Fax
(330) 375-6680
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 35-079157 OH Primary

Addresses

Primary practice location

75 Arch St
Ste. 506
Akron, OH 44304-1429

Mailing address

168 E Market St
PO Box 3542
Akron, OH 44308-2038
Phone (330) 375-3894

Other identifiers 2

IdentifierTypeStateIssuer
2478313MedicaidOH
4135104OtherOHMEDICARE ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040719000113 OH Practitioner - Infectious Disease 2062491558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Northeastern Ohio University College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summa Physicians LLCGroup PAC ID 2961303532, 692 clinicians

Practice addresses (Care Compare)

155 5TH St NE
Barberton, OH 44203-3332

161 N Forge St
Akron, OH 44304-1483

525 E Market St
Akron, OH 44304-1619

75 Arch St
Akron, OH 44304-1434

95 Arch St
Suite 215
Akron, OH 44304-1467
Phone (330) 434-4145

Hospital & facility affiliations

  • Summa Health System Hospital, Akron, OH, CCN 360020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-079157OHMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summa Physicians LLC CurrentSince Jul 1, 2006 Accepting new patients
Summa Physicians LLC Past Accepting new patients

Locations

1077 Gorge Blvd
Akron, OH 44310
Phone (234) 312-5691

Interoperability endpoints

  • Direct secure messaging: mtan19541@summahealth-direct.org

Organizations & group practices 3

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 3

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374105600000",
    "number": "1972556413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 E MARKET ST",
            "address_2": "PO BOX 3542",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443082038",
            "telephone_number": "330-375-3894",
            "fax_number": "330-375-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 ARCH ST",
            "address_2": "STE. 506",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041429",
            "telephone_number": "330-375-3894",
            "fax_number": "330-375-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2013-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "OH",
            "license": "35-079157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2478313",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "4135104",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.