DOUGLAS TAN MD
NPI 1073365235
Student in an Organized Health Care Education/Training Program in Verona, NJ

Q: What is Douglas Tan's NPI number?

The NPI number for Douglas Tan is 1073365235. It was assigned to this individual provider in the NPPES registry on April 2, 2024.

Q: What is Douglas 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 Douglas Tan was last updated on April 2, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 02, 2024PECOS Enrolled

799 BLOOMFIELD AVE STE 201, VERONA, NJ 07044(973) 746-7050 Get Directions Write a Review

NPPES record last updated: April 2, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Douglas Tan Md NPPES

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

DOUGLAS TAN MD (NPI 1073365235) is an individual student in an organized health care education/training program in Verona, New Jersey and active in the NPI registry since April 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073365235

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDOUGLAS TANCredential: MD

Location Address799 BLOOMFIELD AVE STE 201Verona, NJ 07044-1374

Mailing Address799 Bloomfield Ave Ste 201Verona, NJ 07044-1374 · (973) 746-7050

Phone(973) 746-7050

Sole ProprietorNo

Enumeration DateApril 2, 2024

NPPES CertifiedMarch 26, 2024

✔ NPI 1073365235 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.

799 BLOOMFIELD AVE STE 201, Verona, NJ 07044

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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)

Douglas Tan Md 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.

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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.

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