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SIDHARTHA TAN MD
NPI 1154480630
Pediatrics - Neonatal-Perinatal Medicine in Detroit, MI

Active since December 08, 2006PECOS Enrolled
3901 BEAUBIEN, CHILDREN'S HOSPITAL OF MI, DETROIT, MI 48201(313) 745-4405(313) 966-0665 Get Directions Write a Review

NPPES record last updated: March 1, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 1, 2016, Feb 8, 2016 (2 updates tracked since 2016).

About Sidhartha Tan Md NPPES

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

SIDHARTHA TAN MD (NPI 1154480630) is an individual neonatal-perinatal medicine provider in Detroit, Michigan, licensed in Michigan (4301109000) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154480630
Entity TypeIndividualMale
Primary Taxonomy2080N0001X
Provider Legal NameSIDHARTHA TANCredential: MD
Location Address3901 BEAUBIEN, CHILDREN'S HOSPITAL OF MIDetroit, MI 48201
Mailing Address4201 St. Antoine - Uhc 5d - #226, University PediatriciansDetroit, MI 48201-2153 · (313) 745-4405 · Fax (313) 966-0665
Phone(313) 745-4405
Fax(313) 966-0665
Sole ProprietorNo
Enumeration DateDecember 8, 2006
Last NPPES UpdateMarch 1, 20162 updates tracked since enumeration
✔ NPI 1154480630 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Neonatal-Perinatal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080N0001X
Licenses✔ Licensed in MI · 4301109000✔ Licensed in IL · 036068889
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 4301109000 (MI)
3901 BEAUBIEN, Detroit, MI 48201
Open in Google Maps ↗

Other Identifiers 2

Other036068889IL · State License
Other4301109000MI · State License

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sidhartha 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.

Medicare Billing Reassignment

Medicare enrollment records show Sidhartha Tan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Pediatricians
Same address
Nurse Practitioner
3901 BEAUBIEN
Detroit, MI 48201
  • Reassigned Medicare billing, Michigan enrollment
  • 360 clinicians in this Medicare group
NPI 1033143904 (313) 745-5214

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. ALISSA M MARTIN MD
Pediatrics (Pediatric Hematology-Oncology)
3901 BEAUBIEN, CHILDREN'S HOSPITAL OF MI
DETROIT, MI 48201
Wayne County (313) 745-5515
DR. KRISTEN P PETERS AU.D.
Audiologist
3901 BEAUBIEN
DETROIT, MI 48201
Wayne County (313) 745-8903
UNIVERSITY PEDIATRICIANS
Nurse Practitioner
3901 BEAUBIEN
DETROIT, MI 48201
Wayne County (313) 745-5214
CRISTY A. GUAGENTI CPNP
Nurse Practitioner (Pediatrics)
3901 BEAUBIEN, CHILDREN'S HOSPITAL OF MI
DETROIT, MI 48201
Wayne County (313) 745-5260
MERET HENRY M.D.
Pediatrics (Pediatric Hematology-Oncology)
3901 BEAUBIEN, CHILDREN'S HOSPITAL OF MI
DETROIT, MI 48201
Wayne County (313) 745-5515
DANIEL E CALHOUN MSW
Social Worker
3901 BEAUBIEN, UPC CHILDREN'S HOSPITAL/CRISIS CENTER
DETROIT, MI 48201
Wayne County (313) 966-7002
RONALD PHILLIP RUFFING M.D.
Emergency Medicine (Pediatric Emergency Medicine)
3901 BEAUBIEN, CHILREN'S HOSPITAL OF MI/ ER DEPT
DETROIT, MI 48201
Wayne County (313) 745-5260
JANET MARIA POULIK MD
Pathology (Anatomic Pathology & Clinical Pathology)
3901 BEAUBIEN, CHILDRENS HOSPITAL OF MI PATHOLOGY
DETROIT, MI 48201
Wayne County (313) 745-2553

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 Sidhartha Tan's NPI number?

The NPI number for Sidhartha Tan is 1154480630. It was assigned to this individual provider in the NPPES registry on December 8, 2006.

Where is Sidhartha Tan located?

Sidhartha Tan practices at 3901 Beaubien Children's Hospital Of Mi, Detroit, MI 48201. The listed phone number is (313) 745-4405.

What is Sidhartha Tan's specialty?

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

Is Sidhartha Tan enrolled in Medicare?

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

Which organization bills Medicare for Sidhartha Tan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sidhartha Tan reassigns Medicare benefits to University Pediatricians (Detroit, MI). The 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 Sidhartha 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 Sidhartha Tan was last updated on March 1, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.