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DR. LUKAS H TAN M.D.
NPI 1104885789
Pediatrics - Neonatal-Perinatal Medicine in Jacksonville, FL

Active since March 21, 2006PECOS Enrolled
655 W 8TH ST, UFJP NEONATOLOGY, JACKSONVILLE, FL 32209(904) 244-4254(904) 244-4301 Get Directions Write a Review

NPPES record last updated: August 7, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Lukas H Tan M.d. NPPES

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

DR. LUKAS H TAN M.D. (NPI 1104885789) is an individual neonatal-perinatal medicine provider in Jacksonville, Florida, licensed in Florida (ME54721) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104885789
Entity TypeIndividualMale
Primary Taxonomy2080N0001X
Provider Legal NameDR. LUKAS H TANCredential: M.D.
Location Address655 W 8TH ST, UFJP NEONATOLOGYJacksonville, FL 32209-6511
Mailing AddressPo Box 44008, Ufjp Provider EnrollmentJacksonville, FL 32231-4008 · (904) 244-3660 · Fax (904) 244-3425
Phone(904) 244-4254
Fax(904) 244-4301
Sole ProprietorNo
Enumeration DateMarch 21, 2006
Last NPPES UpdateAugust 7, 2019
✔ NPI 1104885789 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Neonatal-Perinatal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080N0001X
License✔ Licensed in FL · ME54721
Definition
A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.
Also ListedPediatricsTaxonomy 208000000X · License ME54721 (FL)
655 W 8TH ST, Jacksonville, FL 32209
Open in Google Maps ↗

Other Identifiers 2

Medicaid3704947-00FL
Medicaid975031480AGA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Lukas H Tan M.d. 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Lukas Tan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Florida Jacksonville Physicians Inc
Same address
Diagnostic Radiology
655 W 8TH ST, UFJP RADIOLOGY
Jacksonville, FL 32209
  • Reassigned Medicare billing, Florida enrollment
  • 1,456 clinicians in this Medicare group
NPI 1326208695 (904) 244-3660
Halifax Healthcare Systems Inc
87 mi
Family Medicine
303 N CLYDE MORRIS BLVD
Daytona Beach, FL 32114
  • Reassigned Medicare billing, Florida enrollment
  • 786 clinicians in this Medicare group
NPI 1245283530 (386) 254-4000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

DR. MATTHEW DUWAIN WARRICK M.D.
Anesthesiology
655 W 8TH ST
JACKSONVILLE, FL 32209
Duval County (904) 244-4195
DR. MARYAM OOJA ABUBAKAR MD, MPH
Pediatrics (Neonatal-Perinatal Medicine)
655 W 8TH ST
JACKSONVILLE, FL 32209
Duval County (904) 244-3508
CHRISTOPHER FULLER PT, DPT
Physical Therapist
655 W 8TH ST
JACKSONVILLE, FL 32209
Duval County (904) 244-0411
WILLIAM RENFRO PHARM. D.
Pharmacist
655 W 8TH ST
JACKSONVILLE, FL 32209
Duval County (904) 244-2179
CAM-TU NGUYEN PHARMD
Pharmacist
655 W 8TH ST
JACKSONVILLE, FL 32209
Duval County (352) 682-4355
LOGAN SMITH PHARMD
Pharmacist
655 W 8TH ST
JACKSONVILLE, FL 32209
Duval County (478) 387-5570
HANNAH BISOGLIO
Student in an Organized Health Care Education/Training Program
655 W 8TH ST
JACKSONVILLE, FL 32209
Duval County (904) 244-0411
DR. CARMELA MONTEIRO MD
Pathology (Anatomic Pathology)
655 W 8TH ST, UFJP PATHOLOGY DEPT
JACKSONVILLE, FL 32209
Duval County (904) 244-4699

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lukas Tan's NPI number?

The NPI number for Lukas Tan is 1104885789. It was assigned to this individual provider in the NPPES registry on March 21, 2006.

Where is Lukas Tan located?

Lukas Tan practices at 655 W 8th St Ufjp Neonatology, Jacksonville, FL 32209. The listed phone number is (904) 244-4254.

What is Lukas Tan's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neonatal-Perinatal Medicine, with taxonomy code 2080N0001X.

Is Lukas Tan enrolled in Medicare?

Yes. Lukas Tan is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Lukas Tan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lukas Tan reassigns Medicare benefits to 2 organizations: University Of Florida Jacksonville Physicians Inc (Jacksonville, FL) and Halifax Healthcare Systems Inc (Daytona Beach, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Lukas Tan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Lukas Tan was last updated on August 7, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.