John L Tan II

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

16933 Issued in NV

Practice address

480 Galletti Way
Sparks, NV 89431-5564

Phone

(775) 688-2001

NPI assigned

Mar 19, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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

Specialty

Psychiatry

Education

Creighton University School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State of NevadaGroup PAC ID 9234022153, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• State of Nevada

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ely, NV
  • NPI 1760572010
  Medicare reassignment Care Compare group NPD
• State of Nevada

  • Skilled Nursing Facility
  • Boulder City, NV
  • NPI 1083612741
  NPD
• State of Nevada

  • Psychiatric Hospital
  • Sparks, NV
  • NPI 1972501021
  NPD
• Southern Nevada Adult Mental Health

  • Adult Mental Health Clinic/Center
  • Las Vegas, NV
  • NPI 1891756920
  NPD (past)

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

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1972845790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W 2ND ST",
            "address_2": "SUITE 216",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895035345",
            "telephone_number": "775-682-8469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 GALLETTI WAY",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894315564",
            "telephone_number": "775-688-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "JOHN",
        "middle_name": "L",
        "name_suffix": "II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-19",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NV",
            "license": "16933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ilse Tadeo Ortega
• Patricia Taggart, PT
• Jose F Talancon, DDS
• Lynette Talbott, PTA
• Edward Tambi, PHARN.D
• Kristina Tartaglini
• Joshua Tartakoff, D.O
• Andrea Malchiodi Tatro, MD
• Asia Tau-Tolliver
• Danelli Taylor, LPN

• Psychiatry Physician in Sparks, NV
• Providers in Sparks, NV by specialty
• Psychiatry Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.