JESSICA TAN MD, PHD
NPI 1023703634
Student in an Organized Health Care Education/Training Program in Philadelphia, PA

Q: What is Jessica Tan's NPI number?

The NPI number for Jessica Tan is 1023703634. It was assigned to this individual provider in the NPPES registry on April 10, 2023.

Q: What is Jessica Tan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jessica Tan was last updated on April 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 10, 2023PECOS Enrolled

111 S 11TH ST STE 8290, PHILADELPHIA, PA 19107(215) 955-2370(215) 955-0677 Get Directions Write a Review

NPPES record last updated: April 10, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jessica Tan Md, Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESSICA TAN MD, PHD (NPI 1023703634) is an individual student in an organized health care education/training program in Philadelphia, Pennsylvania and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1023703634

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameJESSICA TANCredential: MD, PHD

Location Address111 S 11TH ST STE 8290Philadelphia, PA 19107-4824

Mailing Address7819 New Second StElkins Park, PA 19027-2712 · (215) 520-0472

Phone(215) 955-2370

Fax(215) 955-0677

Sole ProprietorNo

Enumeration DateApril 10, 2023

NPPES CertifiedApril 10, 2023

✔ NPI 1023703634 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

111 S 11TH ST STE 8290, Philadelphia, PA 19107

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jessica Tan Md, Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHAEL ROBERT SISKO MD

Student in an Organized Health Care Education/Training Program