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JESSIE TAN
NPI 1609118157
Student in an Organized Health Care Education/Training Program in Detroit, MI

Active since March 22, 2013PECOS EnrolledAccepts Medicare Assignment
2799 W GRAND BLVD, DETROIT, MI 48202(313) 916-2600 Get Directions Write a Review

NPPES record last updated: December 17, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jessie Tan NPPES

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

JESSIE TAN (NPI 1609118157) is an individual student in an organized health care education/training program in Detroit, Michigan and active in the NPI registry since March 2013. He is enrolled in Medicare PECOS and is a graduate of Wayne State University School Of Medicine (2013).

NPPES Registry Identity

NPI1609118157
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJESSIE TAN
Location Address2799 W GRAND BLVDDetroit, MI 48202-2608
Mailing Address2799 W Grand BlvdDetroit, MI 48202-2608 · (313) 916-2600
Phone(313) 916-2600
Sole ProprietorNo
Medical School CMSWayne State University School Of MedicineGraduated 2013
Enumeration DateMarch 22, 2013
Last NPPES UpdateDecember 17, 2021
✔ NPI 1609118157 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.
2799 W GRAND BLVD, Detroit, MI 48202
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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 and accepts Medicare assignment

Jessie Tan is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID446482202
PECOS Enrollment IDI20161118001339
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
26 services26 patients
Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
22 services22 patients

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.

HENRY FORD HOSPITAL
General Acute Care Hospital
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600
DR. BRENT DAVID GRIFFITH M.D.
Radiology (Diagnostic Radiology)
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600
KANIKA KHANNA M.D
Radiology (Diagnostic Radiology)
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600
DR. FADL A CHOKR M.D.
Family Medicine
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600
AVI COHEN M.D.
Internal Medicine (Pulmonary Disease)
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600
LINDSEY AURORA
Internal Medicine (Cardiovascular Disease)
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600
KYLE KRUPA
Nurse Anesthetist, Certified Registered
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600
ALEXANDER GARBARINO
Internal Medicine (Pulmonary Disease)
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600

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 Jessie Tan's NPI number?

The NPI number for Jessie Tan is 1609118157. It was assigned to this individual provider in the NPPES registry on March 22, 2013.

Where is Jessie Tan located?

Jessie Tan practices at 2799 W Grand Blvd, Detroit, MI 48202. The listed phone number is (313) 916-2600.

What is Jessie Tan's specialty?

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

Is Jessie Tan enrolled in Medicare?

Yes. Jessie Tan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jessie Tan was last updated on December 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.