Individual provider Active NPI

Xuejun Tian, M.D., PHD

  • Anatomic Pathology & Clinical Pathology Physician
  • Wayne, PA
National Provider Identifier
1992017024
Registry record updated Apr 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD480226 Issued in PA
Practice address
173 Katharine LN
Wayne, PA 19087-4241
Phone
(718) 954-5848
NPI assigned
Jul 6, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD480226 PA Primary

Addresses

Primary practice location

173 Katharine LN
Wayne, PA 19087-4241

Mailing address

173 Katharine LN
Wayne, PA 19087-4241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 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
I20160831000698 NY Practitioner - Pathology 2466671763 Reassigns benefits to 1 organization
I20230907002946 PA Practitioner - Pathology 2466671763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

2301 S Broad St
Philadelphia, PA 19148-3542
Phone (215) 952-7444

Hospital & facility affiliations

  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174
  • Jefferson Abington Hospital Hospital, Abington, PA, CCN 390231
  • Jefferson Health- Northeast Hospital, Philadelphia, PA, CCN 390115
  • Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086
  • Jefferson Lansdale Hospital Hospital, Lansdale, PA, CCN 390012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD480226PAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Anatomic Pathology & Clinical Pathology CurrentSince Jun 22, 2016 Accepting new patients
Jefferson University Physicians Anatomic Pathology & Clinical Pathology CurrentSince Jul 19, 2023 Accepting new patients
Montefiore Medical Center CurrentSince Jun 22, 2016 Accepting new patients
Tufts Medical Center Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1101 Market St
Fl 19
Philadelphia, PA 19107
Phone (215) 481-6836

2301 S Broad St
Fl 1
Philadelphia, PA 19148
Phone (215) 952-9136

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

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 5

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": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1992017024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 KATHARINE LN",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190874241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 KATHARINE LN",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190874241",
            "telephone_number": "718-954-5848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIAN",
        "first_name": "XUEJUN",
        "credential": "M.D., PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-06",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "PA",
            "license": "MD480226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, PA

Sources for this page

Verify at the official NPI Registry.